Crusted plaques on the right face

A 46-year-old man with a history of biopsy-proven pemphigus presented with progressive crusted plaques across his right face. The physical examination revealed multiple large, erythematous, crusted plaques across the right malar cheek and forehead with sharp demarcation at the midline forehead, sparing the entire left side of the face (Fig 1). The patient described the eruption as intensely pruritic. The eruption coincided with riding in the passenger seat of a car for many hours of the day. A family history revealed multiple relatives with lupus erythematosus.

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