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Visual Treats in Dermatology
2022
:2;
93
doi:
10.25259/CSDM_104_2022

Hypopyon sign in pemphigus vulgaris

Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Corresponding author: Arunachalam Narayanan, Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. narayanan359@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Narayanan A. Hypopyon sign in pemphigus vulgaris. CosmoDerma 2022;2:93.

A 50-year-old man presented to our clinic with oral erosions and vesiculobullous lesions over the body in a generalized distribution for 5 years. Few of these bullae had a bottom layer of pus and clear fluid on the top [Figure 1], demonstrating the “hypopyon sign.” Histopathology and direct immunofluorescence revealed features of pemphigus vulgaris. “Hypopyon sign” or “half-half blister” describes bullae with pus accumulating in the bottom half, especially when the patient stands upright. It is hypothesized that the hypopyon sign results from neutrophil accumulation inside the bullae, which accumulates in its bottom half. While classically described in subcorneal pustular dermatosis, dermatologists need to remember that the morphology can also be seen in other bullous disorders.[1]

Figure 1:: A flaccid blister with a collection of pus in the lower half and clear fluid on the top, demonstrating hypopyon sign.

Declaration of patient consent

Patient’s consent not required as patients identity is not disclosed or compromised.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. , , . Hypopyon sign in pemphigus vulgaris and pemphigus foliaceus. Int J Dermatol. 2009;48:1100-2.
    [CrossRef] [PubMed] [Google Scholar]

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