BackgroundPemphigus foliaceus (PF) is a blistering disorder most commonly 
presenting in middle age. As PF is restricted to the superficial epidermis, it 
is considered more benign than other pemphigus diseases. However, progression to 
severe disease is not uncommon. Although rituximab's efficacy has been 
well-documented in adults with refractory PF, little data is available on its 
role in adolescents.PurposeWe describe a patient with juvenile PF treated with 
rituximab and review the literature for similar cases.MethodsPubMed was searched 
for the terms: antibody, B cells, blistering, CD20, foliaceus, juvenile, 
pemphigus, rituximab, immunosuppression. As the first reported case of rituximab 
treated pemphigus was in 2001, only cases from 2001 and after were included. 
Juvenile PF was defined as disease diagnosis between ages 12-17.ResultsFive 
cases have been reported. The indication for rituximab in most cases was 
refractory PF unresponsive to systemic glucocorticoids and non-steroidal 
adjuvant therapies. All cases demonstrated significant improvement or complete 
remission and most experienced no adverse events.ConclusionsRituximab appears to 
be both well tolerated and efficacious for refractory juvenile PF. Therefore, it 
may be considered for severe cases of PF to avoid side effects associated with 
conventional glucocorticoid therapy.