Coexistence of pemphigus and bullous pemphigoid.

In three patients there was evidence of concurrent pemphigus and bullous pemphigoid. Each of the patients had both pemphigus and bullous pemphigoid antibodies in the serum, and IgG deposits were found in both intercellular and basement membrane zone regions by direct immunofluorescent examination. One patient presented the clinical, histologic, and immunologic features of both these diseases at the onset of her illness. Two other patients had been shown to have pemphigus vulgaris alone for a number of months or years before the combined disease appeared. Repeated immunologic and histologic examinations are essential in the study of the major bullous diseases. An underlying complex of immunologic disturbances may be operative in the production of such cases of combined disease.