Systemic Lupus Erythematosus With Pemphigus Vulgaris

To the Editor.—  Systemic lupus erythematosus (SLE) is a collagen vascular disease with multisystem involvement, including often the integument. Pemphigus is a group of bullous diseases affecting the skin and mucous membranes.¹ Although both conditions are generally believed to be part of the autoimmune spectrum, each have distinctive clinical and immunopathologic characteristics. Pemphigus is also an organ-specific autoimmune disease with antibodies targeted only on the skin and mucous membranes with stratified epithelia, whereas SLE is non-organ specific autoimmune disease with several types of antinuclear antibodies (ANA) affecting many organs. We describe herein a patient with definite evidence of SLE in whom typical features of pemphigus vulgaris developed four months later, while the patient was receiving corticosteroid therapy.

Report of a Case.—  A 59-year-old Chinese woman was seen at the Singapore General Hospital in July 1982, because of a sixmonth history of polyarthritis involving the knees, elbows, wrists, and fingers.