Pemphigus foliaceus is an autoimmune, intraepidermal blistering disease characterized by crusted patches and erosions.

Skin biopsy shows intraepidermal bullae or acantholysis (separation of epidermal cells) in upper epidermis and mild to moderate eosinophil infiltration.

Disease begins gradually on the face in a ‘butterfly’ distribution, or first appears on scalp, chest, or upper back as localized or broad areas of erythema, scaling, crusting, or occasionally bullae.