Pemphigus erythematosus, like other variants of pemphigus and lupus erythematosus, may be increased in patients who express specific HLA haplotypes. Those identified in pemphigus erythematosus are A10 or A26 and DRW6. Reports generally find no difference in occurrence between the two sexes, although some studies from India suggest a male preponderance. Onset and progression are typically slow. While the distribution of the lesions should suggest induction by sunlight the patient may be completely unaware of the photosensitive nature of the disorder.
Lesions typically involve the scalp, face, upper chest, and back.
Patients with pemphigus erythematosus classically present with small flaccid bullae with scaling and crusting. Occasionally the appearance may suggest a papulosquamous disorder. Secondary infection may occur, resulting in impetiginzation, healing with pigment changes, and scarring. With extensive involvement, patients may present with an exfolliative erythroderma Skin may be tender. Patients with pemphigus erythematosus do not typically develop mucous membrane involvement, as can be seen in some other variants of pemphigus.