Introduction: Pemphigus vulgaris is a rare, autoimmune disorder characterized by blistering skin and mucous membrane lesions, often presenting with oral lesions in 50-70% of cases. It has a global incidence of 0.5-3.2 per 100,000 people, with variations across regions, and in Iran, the rate is about 1 per 100,000 annually. The disease typically manifests in the 6th decade of life, though the age of onset varies internationally, being younger in India and Western countries. Method: In this cross-sectional study, information of 63 patients, diagnosed with pemphigus vulgaris was confirmed by biopsy of the lesions, was collected during a telephone call. This project was approved by the Research Ethics Committee of Iran University of Medical Sciences. SPSS version 22 software was used for the statistical analysis of the data. Results: In a study of 63 pemphigus vulgaris patients, 56% were female and 44% male, with an average age of 50.17 years. Most patients initially presented with mucosal symptoms (70%), and the average time to diagnosis was about 17 months. Common misdiagnoses included aphthous ulcers, lichen planus, and allergic reactions. Post-diagnosis, most patients (82%) received multiple medications. Specific treatments included prednisolone (12%), methylprednisolone (1.7%), and methotrexate (1.7%). Also Those who initially managed their illness well tended to have more frequent and intense flare-ups later. Patients diagnosed early generally had fewer relapses, while those who first showed mucosal symptoms experienced longer periods without relapses. Also, being diagnosed late can affect how well treatments work and how the disease is managed. Discussion: Pemphigus vulgaris predominantly affects middle-aged women, typically emerging in their fifth decade, with mucosal symptoms often preceding skin manifestations. Delayed diagnosis, particularly in cases presenting with skin symptoms, may impact prognosis. Treatment choice and adjuvant therapy post-diagnosis may influence relapse rates, warranting further investigation.

AbstractPityriasis rubra pilaris (PRP) is a rare papulosquamous skin condition that affects both adults and the pediatric population. It is characterized by salmon-colored plaques with islands of sparing and palmoplantar hyperkeratosis. Currently, there are no established guidelines for PRP treatment, especially in pediatric patients. In this study, we presented an infant case of type III juvenile PRP successfully treated with a short-term, low-dose cyclosporine A (CsA). No recurrence occurred during the 3-month follow-up period after completing treatment. Additionally, we reviewed the use of CsA as an alternative treatment option for juvenile-onset PRP. The results of this study were consistent with previous findings for adult-onset PRP. Therefore, this study further supports using CsA as an alternative option for treating juvenile-onset PRP.

Introduction:Lichen Planus is a skin disease that can also affect the mucous membranes and nails (1, 2). The skin manifestations of this disease are multiple purple papules often accompanied by itching (3). The mucosal involvement of this disease is known as mucosal erosions that often involve the oral mucosa and genital area (4).One of the rare types of this skin disease is called ulcerative lichen planus, which presents as chronic ulcers resistant to treatment, associated with pain and many disabilities for patients (5, 6). The involvement of the soles of the feet is one of the most significant areas affected by ulcerative lichen planus. Despite several treatment options having been studied in the past, treating plantar ulcerative lichen planus remains a challenge for dermatologists (4-8).Tofacitinib, a Janus Kinase inhibitor, has a special place in the treatment of inflammatory diseases in medicine (9). Recently, studies have shown its effectiveness in treating various skin diseases such as psoriasis, alopecia areata, vitiligo, and atopic dermatitis (10). In recent studies, the effectiveness of this drug in treating certain types of lichen planus has been mentioned, including lichen planopilaris and erosions of the oral mucosa (9, 11).In this article, we presented a case of plantar ulcerative lichen planus that was initially resistant to treatment but exhibited a remarkable response upon being treated with oral tofacitinib. In addition, we conducted a comprehensive review of literature on the efficacy of tofacitinib in treating various types of lichen planus lesions, while also discussing other proposed treatments for plantar ulcerative lichen planus.