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/cm(2) power density and 210 J/cm(2) 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.