Document Type

Article

Publication Date

6-2026

Comments

This article is the author's final published version in JAAD Reviews, Volume 8, June 2026, Pages 177-182.

The published version is available at https://doi.org/10.1016/j.jdrv.2026.04.010. Copyright © 2026 The Author(s).

Abstract

Background: Pemphigus vulgaris (PV) is a rare, often severe autoimmune disease affecting skin and mucous membranes. Despite the scarce literature on PV in skin of color (SOC) populations (Fitzpatrick III-VI), existing studies suggest that there are misdiagnosis, delayed treatment, and recurrence of symptoms in SOC patients with PV. Objective: This review explores the clinical presentations of PV reported in patients with SOC, diagnostic challenges and delays, treatments, and patient outcomes to allow for an improved understanding of how PV manifests clinically in darker skin. Methods: A systematic literature review was conducted using articles found in PubMed and Embase. Two independent reviewers screened the articles, and data from 11 articles were extracted. Results: Across 11 PV articles in SOC, scalp involvement occurred in 8 cases, ocular involvement in 2, and diagnostic challenges due to misdiagnosis or delayed recognition occurred in 6. Morphological presentations included hyperkeratotic plaques (n = 4), pustules with hypopyon (n = 1), and pigmented lesions secondary to postinflammatory hyperpigmentation and hypopigmentation (n = 5). Four cases demonstrated recurrent or persistent disease after treatment. Conclusion: In reporting PV presentations in SOC, this review aims to improve recognition of PV in these populations, thereby improving patient outcomes and limiting cases of misdiagnosis and disease recurrence.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Language

English

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