Unusual Case of Pemphigus Vulgaris Mimicking Localized Pustular Psoriasis of the Hands and Feet

We report a case of a 70-year-old man with a history of chronic plaque psoriasis presenting with new-onset vesiculopustules of the hands and feet. Hematoxylin and eosin stain as well as direct and indirect immunofluorescence were all consistent with a diagnosis of pemphigus vulgaris. Unusual presentations of pemphigus vulgaris have been reported in the literature. Our case easily could have been clinically misdiagnosed as pustular psoriasis.