Pemphigus is an autoimmune blistering disorder that, prior to the use of prednisone, was associated with increased mortality.1 Even with the availability of steroid-sparing agents, moderate to severe disease can be associated with clinically significant morbidity. In this issue, Hsu et al2 demonstrate the financial burden of inpatient hospitalization of patients with pemphigus using the National Inpatient Sample (NIS) Database. The NIS is the largest publicly available all-payer hospital inpatient care database in the United States and is used by researchers and policymakers to identify, track, and analyze trends in health care utilization, access, charges, quality, and outcomes.3 Rare diseases, such as pemphigus, can be difficult to study, but large databases, such as the NIS, allow us a glimpse into the impact of the disease from a public health perspective. Hsu et al2 demonstrate that even a relatively rare dermatologic condition can be a considerable burden both to the patient and the medical system.