Abstract
RATIONALE: Currently, the main comorbidities of psoriasis are cardiovascular, metabolic, liver and kidney, autoimmune, and psychological disorders. Psoriasis associated with pemphigus is relatively rare. This rare disease presents with significant clinical, diagnostic, and therapeutic challenges. PATIENT CONCERNS: The patient was a 71-year-old man with recurrent erythema, papules, and scales with itching all over the body for 11 years, accompanied by blisters and erosions for more than 1 month, and aggravated by generalized eruption for 1 week. The patient was diagnosed with pemphigus vulgaris and admitted to our hospital with intravenous methylprednisolone combined with a conventional oral antihistamine and topical hormonal ointment. The patient's symptoms significantly disappeared. The patient complained that his condition recurred easily after discontinuing medication, which seriously affected his daily life and sleep. The patient also had essential hypertension, nail psoriasis, tinea pedis, and onychomycosis. DIAGNOSES: The patient was diagnosed with psoriasis vulgaris with coexisting pemphigus vulgaris. INTERVENTIONS: The patient was treated with modest doses of glucocorticoids combined with secukinumab and methotrexate. OUTCOMES: The patient's generalized skin lesions and fingernails and toenails of the hands and feet healed virtually. There was no recurrence at 8 months follow-up, and no adverse effects were noted. LESSONS: Moderate-dose glucocorticoids combined with secukinumab and methotrexate may be an option for treating psoriasis and pemphigus vulgaris. This case allows us to consider whether we can treat psoriasis vulgaris combined with pemphigus vulgaris based on a common pathogenesis, and to guide us in clinical dosing.