An 85-year-old woman developed complete esophageal obstruction from benign mucous membrane pemphigoid. Electron microscopic examination of nonscarring cutaneous lesions revealed two patterns. The first pattern showed early degenerative changes of epidermal cells with loss of tonofilaments and hemidesmosomes; the second showed frank dermoepidermal cleavage within the intermembranous space in the presence of polymorphonuclear leukocytes and without any epidermal degeneration.