: Pemphigus is a chronic autoimmune vesiculobullous disease caused by autoantibodies directed against desmogleins (Dsgs). Pemphigus vegetans is a rare variant of pemphigus vulgaris, characterized by vegetative plaques, primarily occurring in flexures. It is a less common disease and involves the skin and mucosa due to disintegration of cellular adherence (acantholysis), resulting in intradermal split. We report this case of pemphigus vegetans of Neumann type for its rare presentation. We report a case of pemphigus vegetans, involving lips in a middle-aged female and sparing flexural areas. This patient was diagnosed on the basis of histopathology and treated successfully with intralesional steroids, resulting in the resolution of her plaques.
: Facial ulcers may be the manifestation of a wide variety of disorders with infective, inflammatory, granulomatous, or malignant etiopathogenesis, leading to challenges in differential diagnosis and management. Mucormycosis is an angio-invasive, rapidly spreading, and potentially fatal fungal infection beginning from the nose and paranasal sinuses after the inhalation of fungal spores, manifesting with cutaneous necrotic eschar. The rhinomaxillary region is the commonest site involved, particularly in immunocompromised individuals. Mucormycosis incidence in people with coronavirus disease 2019 (COVID-19) is on the rise, especially in India during the second wave. Diabetes mellitus is an independent risk factor for severe COVID-19 infection, as well as for mucormycosis. We report an elderly gentleman with uncontrolled diabetes, treated for the COVID-19 infection, who presented with an ulcer over the left nasal ala. This case report highlights the importance of high-index suspicion and prompt and aggressive multidisciplinary management of mucormycosis, as a life-saving measure.
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