Pemphigus vulgaris presenting with multiple lesion morphologies

Abstract

Pemphigus vulgaris is an uncommon intraepidermal blistering disorder that typically presents with flaccid bullae or erosions. We report a patient with pemphigus vulgaris who presented with several unusual clinical features: tense bullae with dependently layered pus, true target lesions coalescing into annular configurations, and diffuse desquamation that initially raised concern for toxic epidermal necrolysis. We discuss the differential diagnosis and implications of these morphological findings.