ABSTRACT
This chapter presents a case study of a 29-year-old lawyer who attends the accident and emergency department with a sudden and severe skin eruption. She has a 3-day history of a rapidly progressing, painful, erosive eruption affecting her upper trunk and intertriginous areas. She is unable to sleep and finds dressing and undressing difficult as her skin ‘sticks’ to her clothes and tears off. The eruption is occurring on the background of a 4-month history of painful ‘ulcers’ in her mouth and on closer questioning also her genital skin, which she had attributed to stress. The presence of flaccid blisters on an inflammatory base affecting the skin and mucosa in this age group is most suggestive of a diagnosis of pemphigus vulgaris. Pemphigus is a chronic skin disease associated with significant morbidity and formerly, before the synthetic corticosteroid era, a significant mortality due to infection and electrolyte imbalance secondary to fluid loss.
