We report 3 cases of pemphigus vulgaris (PV) confirmed by histology and direct and indirect immunofluorescence that showed transition to pemphigus foliaceus (PF) 2–4 years from the time of disease onset. Desmoglein (Dsg) ELISA testing of the sera from these 3 patients in the later stages of their disease showed the presence of anti-Dsg1 antibodies and the absence of anti-Dsg3 antibodies. These patients were on prednisolone and immunosuppressives at the time the sera were tested, and it is unclear if the transition from PV to PF is a permanent one or whether it is due to preferential suppression of Dsg3 antibodies below a certain threshold. Previously reported cases of transition from PV to PF and PF to PV are summarized.

Hashimoto T, Konohana A, Nishikawa T: Immunoblot assay as an aid to the diagnosis of unclassified cases of pemphigus. Arch Dermatol 1991;127:843–847.
Iwatsuki K, Takigawa M, Hashimoto T, Nishikawa T, Yamada M: Can pemphigus vulgaris become pemphigus foliaceus? J Am Acad Dermatol 1991;25:797–800.
Kawana S, Hashimoto T, Nishikawa T, Nishiyama S: Changes in clinical features, histologic findings, and antigen profiles with development of pemphigus foliaceus from pemphigus vulgaris. Arch Dermatol 1994;13:1534–1538.
Chorzelski TP, Hashimoto T, Jablonska S, et al: Pemphigus vulgaris transforming into pemphigus foliaceus and their coexistence. Eur J Dermatol 1995;5:386–390.
Chang SN, Kim SC, Lee IJ, Seo SJ, Hong CK, Park WH: Transition from pemphigus vulgaris to pemphigus foliaceus. Br J Dermatol 1997;137:303–305.
Ishii K, Amagai M, Ohata Y, Shimizu H, Hashimoto T, Ohya K, Nishikawa T: Development of pemphigus vulgaris in a patient with pemphigus foliaceus: Antidesmoglein antibody profile shift confirmed by enzyme-linked immunosorbent assay. J Am Acad Dermatol 2000;42:859–861.
Komai A, Amagai M, Ishii K, Nishikawa T, Chorzelski T, Matsuo I, Hashimoto T: The clinical transition between pemphigus foliaceus and pemphigus vulgaris correlates well with the changes in autoantibody profile assessed by an enzyme-linked immunosorbent assay. Br J Dermatol 2001;144:1177–1182.
Kimoto M, Ohyama M, Hata Y, Amagai M, Nishikawa T: A case of pemphigus foliaceus which occurred after five years of remission from pemphigus vulgaris. Dermatology 2001;203:174–176.
Tsuji Y, Kawashima T, Yokota K, Tateish Y, Tomita Y, Matsumura T, Shimizu H: Clinical and serological transition from pemphigus vulgaris to pemphigus foliaceus demonstrated by desmoglein ELISA system. Arch Dermatol 2002;138:95–96.
Toth GG, Pas HH, Jonkman MF: Transition of pemphigus vulgaris into pemphigus foliaceus confirmed by antidesmoglein ELISA profile. Int J Dermatol 2002;41:525–527.
Harman KE, Gratian MJ, Shirlaw PJ, Bhogal BS, Challacombe SJ, Black MM: The transition of pemphigus vulgaris into pemphigus foliaceus: A reflection of changing desmoglein 1 and 3 autoantibody levels in pemphigus vulgaris. Br J Dermatol 2002;146:684–687.
Amagai M, Tsunoda K, Zillikens D, Nagai T, Nishikawa T: The clinical phenotype of pemphigus is defined by the anti-desmoglein autoantibody profile. J Am Acad Dermatol 1999;40:167–170.
Delmonte S, Kanitakis J, Cozzani E, Parodi A, Rebora A: Diagnosing pemphigus foliaceus: A retrospective analysis of clinical, histological and immunological criteria. Dermatology 2001;203:289–293.
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