Childhood pemphigus foliaceus typically causes erythema and scaling of the scalp. Sometimes, blisters and oozing are present, which often are misdiagnosed as either impetigo or seborrheic dermatitis. The eruption may progress to involve the trunk and limbs, the lesions often having an arcuate pattern. The diagnosis can be established by histologic and immunologic evaluation. In children, the disease seems to be less severe than pemphigus vulgaris, as is the case with adults, and we recommend a trial of topical steroids before embarking on systemic therapy.