Is 640 nm high-fluence visible red light a valuable adjunct for treating pemphigus vegetans? A single case report.

BACKGROUND: Pemphigus vegetans is an autoimmune bullous disorder characterized by vegetating lesions commonly over the flexures. This disorder is characterized by vegetating lesions more commonly over flexures. Cerebriform tongue, a morphology with typical pattern of sulci and gyri over dorsum of the tongue, is a well-known sign seen in pemphigus vegetans. AIMS: To emphasize the exceptional but successful use of corticosteroid and 640 nm high-fluence visible red light in pemphigus vegetans. METHODS: The patient was successfully treated with low dose systemic corticosteroid (methylprednisolone 20 mg daily) and high-fluence 640 nm LED red light on pustules and exudates (LIFOTRONICR, 120 mw/cm2 power density and 210 J/cm2 energy density). RESULTS: The cerebriform plaques improved quickly after the treatment of corticosteroid and 640 nm high-fluence visible red light. CONCLUSION: We propose to consider low dosage of methylprednisolone and 640 nm high fluence visible red light as first-line monotherapy in pemphigus vegetans, especially in elderly patients with comorbidities and contraindications to standard therapy, as it avoids the toxicities of systemic corticosteroids and immunosuppressants.