Bullous Pemphigoid and Ulcerative Colitis

To the Editor.—  In the March 1991 issue of the Archives, Nemeth et al¹ report a case of childhood bullous pemphigoid unique in that the patient was the youngest described so far. The discussion was excellent. It included a wonderful chart on the differential diagnosis of childhood bullous lesions. The authors mention the association of bullous pemphigoid and ulcerative colitis. They referenced a case of bullous pemphigoid and ulcerative colitis in children² but stated that, to their knowledge, no adult patient with bullous pemphigoid with ulcerative colitis has been described.I call attention to an article published in the International Journal of Dermatology concerning a 21-year-old white woman who had ulcerative colitis for 14 years and then presented with generalized severe bullous pemphigoid.³ Following the resection of her involved intestine, her skin showed marked, but only temporary, clinical improvement. Direct immunofluorescence was performed on the