Pemphigus Vulgaris. Presented by John S. Strauss, MD.
This 67-year-old woman has had an eruption involving her neck, chest, abdomen, and hard palate for four years. Painful ulcers developed in the mouth which were thought to be aphthae. Because of progression of the oral ulcerations, she was hospitalized for study, at which time skin lesions appeared. A biopsy was consistent with pemphigus vulgaris. Adequate control was achieved by 20 mg of prednisone daily and subsequent maintenance by 10 mg daily, until one year ago when all medication was discontinued. The resultant flare-up was severe, and a steroid dosage of 60 mg was required to produce satisfactory response. This dosage was successfully reduced to and maintained at 15 mg daily, but the dermatosis flared again in December 1967. The current dosage is 60 mg daily.Multiple denuded crusted lesions, varying in size, on the abdomen, chest, the left side