Verrucous porokeratosis of Mibelli on the buttocks mimicking psoriasis.

The typical presentation of porokeratosis of Mibelli is of a solitary plaque with a prominent raised border cleaved by a central furrow. The central portion of the plaque is usually slightly atrophic. The plaques vary in size from a few millimeters to several centimeters in diameter and tend to be acrally distributed, though they can occur on any part of the body. We report an unusual case of verrucous porokeratosis of Mibelli, localized to the natal cleft, that mimicked psoriasis. This entity, though unusual, is not unique. Two similar cases of verrucous porokeratosis of Mibelli limited to the natal cleft region and resembling psoriasis have been reported in the British literature. Verrucous porokeratosis of Mibelli localized to the natal cleft appears to be a distinct clinical entity that can mimic psoriasis. Better recognition of this form of porokeratosis of Mibelli may result in earlier diagnosis and initiation of appropriate therapy.

Paraneoplastic pemphigus herpetiformis with IgG antibodies to desmoglein 3 and without mucosal lesions.

BACKGROUND: Pemphigus herpetiformis (PH) is a rare clinical entity that combines the clinical features of dermatitis herpetiformis and the immunopathologic features of pemphigus. The target antigen is usually desmoglein 1, with exceptional cases manifesting autoantibodies against desmoglein 3. More recently, it has been found that many patients with PH also demonstrate autoantibodies against desmocollin. The association of PH with a malignant neoplasm is rare. OBSERVATIONS: We describe a patient with PH and a lung neoplasm. Immunologic studies demonstrated IgG antibodies to desmoglein 3 and to an unknown 178-kDa protein but no antibodies to desmocollin. CONCLUSIONS: The association of PH with a thoracic malignant neoplasm has been reported in only 4 previous cases, and the neoplasm could be responsible for the unusual immunologic profile in the patient described herein. To our knowledge, this is the first report of PH with an associated neoplasm in which only anti-desmoglein 3 antibody was detected.