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March 1984

Bullous Pemphigoid, Myasthenia Gravis, and Thymoma

Arch Dermatol. 1984;120(3):397. doi:10.1001/archderm.1984.01650390119026

The association of bullous pemphigoid (BP) with other autoimmune diseases has been the subject of several recent review articles.1-3 Among the diseases that reportedly occur with BP are rheumatoid arthritis, lupus erythematosus, pernicious anemia, primary biliary cirrhosis, polymyositis, polymyalgia rheumatica, diabetes mellitus, ulcerative colitis, pemphigus vulgaris, dermatitis herpetiformis, lichen planus, vitiligo, alopecia areata, and psoriasis.1-4 A recent report adds Hashimoto's thyroiditis to the list.5 These cases indirectly support the theory of an autoimmune pathogenesis of BP.

Many case reports have linked pemphigus to myasthenia gravis (MG) and thymoma.1 However, my review of the literature failed to disclose a case of BP associated with MG or thymoma. I describe a patient in whom all three diseases were present.

Report of a Case  In August 1981, a 66-year-old woman had an intensely pruritic eruption of two weeks' duration. The lesions had first appeared on her arms as small,

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