Pemphigus Vulgaris With a High Titer of Antinuclear Antibodies

To the Editor.—  It is well known that pemphigus may be associated with other autoimmune diseases, including myasthenia gravis,¹ primary hypothyroidism and diffuse toxic goiter of Graves' disease,² pernicious anemia,³ bullous pemphigoid,⁴ and lupus erythematosus (LE).⁵ Most of the cases of pemphigus coexisting with other autoimmune conditions, particularly LE, are of the erythematous and foliaceous type. We report a case of pemphigus vulgaris having a high titer of antinuclear antibodies (ANAs).

Report of a Case.—  A 74-year-old man had a vesicular eruption of three months' duration. He was receiving no medication when the disease appeared.Physical examination showed no abnormalities. The blisters were found to be present on the scalp, side of the nose, chest, umbilicus, and groin. The bullae were flaccid with a small erythematous halo. Nikolsky's sign was present. A few erosions were found on the mucous membranes of the mouth, particularly on