An 18-year-old Japanese woman came to our hospital with a history of oral erosions for six months, resulting in inadequate feeding with recent development of small blisters and erosions on the skin. At presentation, in addition to erosions on the oral mucosa resembling mucous lesions of pemphigus vulgaris (PV), multiple erosions accompanied by erythematous haloes on the skin of the head, trunk of the body, and extremities were observed (Fig. ia,b). Also, small tense blisters with hyp-opyon pustules were noted (Fig. ib, inset). Biopsy specimen of a skin blister showed intraepidermal vesicles and acantholysis (Fig. ic).
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