{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T16:37:50Z","timestamp":1770223070455,"version":"3.49.0"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pemphigus vulgaris (PV) is a rare, potentially life-threatening autoimmune blistering disorder primarily affecting the skin and mucous membranes. We present a unique case of delayed diagnosis in a patient with PV, initially manifesting as isolated, extensive and therapy-resistant paronychia. PV was only considered after the appearance of mucocutaneous lesions \u2013 first oral, then cutaneous \u2013 more than 1 year after symptom onset. Diagnosis was ultimately established through histopathological examination, direct immunofluorescence and serological testing. Following diagnosis, the patient received rituximab therapy, resulting in a rapid and sustained clinical remission. This case underscores the importance of considering PV in the differential diagnosis of severe, chronic and treatment-resistant paronychia. Early recognition and diagnosis are crucial for timely intervention, which can significantly improve patient outcomes. Rituximab proved highly effective in this case, aligning with current evidence supporting its use as a first-line treatment for PV. We aim to raise awareness of atypical PV presentations and stress the need for thorough evaluation of persistent, treatment-resistant paronychia to prevent delayed diagnosis.<\/jats:p>","DOI":"10.1093\/skinhd\/vzaf094","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T12:39:15Z","timestamp":1762173555000},"page":"71-74","source":"Crossref","is-referenced-by-count":0,"title":["Unmasking: paronychia as the hidden face of pemphigus"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9900-2982","authenticated-orcid":false,"given":"Anke","family":"Lambert","sequence":"first","affiliation":[{"name":"Department of Dermatology, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An","family":"Van Laethem","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Callens","sequence":"additional","affiliation":[{"name":"Private Practice in Dermatology \u2018De Huidspecialisten\u2019 , Boortmeerbeek ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Verhamme","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Steegmans","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Bosisio","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"De Haes","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"2026020400220485600_vzaf094-B1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jaad.2013.09.042","article-title":"Clinical and cytologic features of antibiotic-\u00adresistant acute paronychia","volume":"70","author":"Durdu","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"2026020400220485600_vzaf094-B2","doi-asserted-by":"crossref","first-page":"e8954","DOI":"10.1002\/ccr3.8954","article-title":"Juvenile pemphigus \u00advulgaris: literature review and a rare case report","volume":"12","author":"Sriram","year":"2024","journal-title":"Clin Case Rep"},{"key":"2026020400220485600_vzaf094-B3","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1111\/ijd.17257","article-title":"Nail changes in pemphigus: a systematic review and meta-analysis","volume":"63","author":"Ng","year":"2024","journal-title":"Int J Dermatol"},{"key":"2026020400220485600_vzaf094-B4","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1111\/jdv.16752","article-title":"Updated S2K guidelines on the management of pemphigus vulgaris and foliaceus initiated by the European Academy of Dermatology and Venereology (EADV)","volume":"34","author":"Joly","year":"2020","journal-title":"J\u00a0Eur Acad Dermatol Venereol"},{"key":"2026020400220485600_vzaf094-B5","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1159\/000155645","article-title":"Orodigital pemphigus vulgaris: a pathogenic role of anti-desmoglein-3 autoantibodies in pemphigus paronychia?","volume":"217","author":"Laffitte","year":"2008","journal-title":"Dermatology"},{"key":"2026020400220485600_vzaf094-B6","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1067\/mjd.2000.106236","article-title":"Nail involvement in pemphigus vulgaris","volume":"43","author":"Engineer","year":"2000","journal-title":"J Am Acad Dermatol"},{"key":"2026020400220485600_vzaf094-B7","first-page":"e58288","article-title":"Rituximab in childhood and juvenile pemphigus vulgaris: a systematic review","volume":"16","author":"Shrivastava","year":"2024","journal-title":"Cureus"}],"container-title":["Skin Health and 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