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Pemphigus Vulgaris. Presented by Dr. R. E. Barney.
Mrs. S. L., a woman aged 70, was first seen on Nov. 5, 1940. She stated that she had had an intermittent itchy eruption over the body for the past three years. In September 1940 blisters had developed on her trunk and extremities.Examination reveals pea-sized to plum-sized bullous lesions on the arms, thighs and, to a less extent, trunk. For the most part they seem to arise from normal skin. Some are tense while others are flaccid. The contents of most of the bullae are serous, but a few contain blood and others pus. Some have ruptured, leaving erosions and crusts. On the trunk and extremities there are dime-sized to silver dollar—sized erythematous areas, which are the sites of previous blebs.The mucous membranes are not involved. Nikolsky's sign cannot be elicited. Constitutional signs are absent, but the itching is so