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June 1977

Bi-Directional Isomorphism: Coexistence of Psoriasis Vulgaris and Familial Benign Chronic Pemphigus

Arch Dermatol. 1977;113(6):846-847. doi:10.1001/archderm.1977.01640060142025

To the Editor.—  We wish to report on the co-existence in two patients, found to be first cousins, of psoriasis vulgaris and familial benign chronic pemphigus (FBCP).

Report of Cases.—Case 1.—  A woman aged 44 who came to us in 1961 with a maculopapular erythema of the axillae, perineum, natal cleft, and sub-mammary region for six years, and dry scaly psoriasis elsewhere, was regarded as having infected flexural psoriasis. After four months' treatment, she was clear. Ten years later she was referred again and after three months' treatment her lesions settled. She was referred by a third practitioner 11 months later, with a rash in the groins, and with blisters for the first time. This time the skin lesions did not respond to outpatient treatment and she was admitted to hospital for biopsy that showed a suprabasal acantholytic cleft with no dyskeratosis, and "villous" budding of the basal layer, diagnostic

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