PEMPHIGUS VEGETANS

Abstract

IN PEMPHIGUS vegetans, in contradistinction to pemphigus vulgaris, there is close agreement concerning histologic changes. These are acanthosis and papillomatosis involving predominantly the rete pegs (ridges) and microabscesses within the hyperplastic rete pegs containing large numbers of eosinophiles. I cite a few representative opinions without attempting to review all sources. Montgomery and co-workers¹state that the histologic changes of pemphigus vegetans are quite distinctive and may occur at any level of the epidermis. Ormsby and Montgomery²are in general agreement, adding that eosinophiles also predominate in the papillae and that there is a resemblance to blastomycosis and bromoderma. Lever³agrees and mentions that early there is low-level acantholysis as in Darier's disease (keratosis follicularis) but without dyskeratosis; that older lesions show no bullae but only acanthosis and papillomatosis resembling pseudoepitheliomatous hyperplasia, while the intraepidermal abscesses resemble bromoderma and pyogenic granuloma. Civatte,⁴also in