On the issue of differential diagnosis of true pemphigus complicated by candidal infection in neoplastic diseases

The term "acantholytic pemphigus" encompasses a group of heterogeneous, chronic, autoimmune bullous dermatoses characterized by potential involvement of both the skin and mucous membranes. The differential diagnosis between disease variants such as pemphigus vulgaris (PV) and paraneoplastic pemphigus (PNP) commonly presents considerable challenges. At present, the principal modality for the verification of acantholytic pemphigus, in conjunction with morphological assessment, involves immunomorphological techniques — including, most notably, direct immunofluorescence — which enable the detection of immune complex deposition in various layers of the skin. This article examines the role of immunomorphological research in the differential diagnosis of PV and PNP. Based on the clinical case presented, it is posited that PV may arise in the context of a neoplastic process independently of paraneoplastic syndrome. KEYWORDS: true pemphigus, paraneoplastic pemphigus, candidal infection, immunomorphological research. FOR CITATION: Karzanov O.V., Kupriyanova A.G., Baranov I.A., Rudakova V.Yu., Kornyushenko V.O., Zotov A.I., Molochkov A.V. On the issue of differential diagnosis of true pemphigus complicated by candidal infection in neoplastic diseases. Russian Medical Inquiry. 2025;9(7):426– 431 (in Russ.). DOI: 10.32364/2587-6821-2025-9-7-6