Pemphigus foliaceous following vaccinations

Pemphigus is a rare autoimmune bullous disease, with pemphigus vulgaris (PV) and pemphigus foliaceous (PF) being its most common forms. This report presents a case of PF triggered by vaccinations. A previously healthy 38-year-old Caucasian man developed skin lesions six months after receiving vaccinations for hepatitis A, rabies, cholera, typhoid fever, and yellow fever before travelling to Sudan. Examination revealed pruritic erosions, crusts, and flaccid blisters primarily on the trunk and limbs. Histopathology was nonspecific, but direct immunofluorescence showed intercellular IgG, C3c, and C1q deposits. Elevated autoantibodies against desmoglein 1 (DSG1) confirmed the PF diagnosis. The patient responded well to oral prednisone and topical treatments, with complete resolution of symptoms within six months. The aetiology of pemphigus remains unclear, but vaccines can nonspecifically activate the immune system, potentially triggering pemphigus in predisposed individuals. This case highlights the need to consider pemphigus as a potential adverse effect of vaccination.