Coexistence of pemphigus vulgaris and ocular cicatricial pemphigoid

We describe the case of a patient with both pemphigus vulgaris limited to the oral cavity and ocular cicatricial pemphigoid.The diagnoses were established by means of histopathologic examination and direct and indirect immunofluorescence studies and confirmed by immunoblot analysis of serum.Treatment with dapsone resulted in a prolonged remission of the ocular cicatricial pemphigoid.The pemphigus vulgaris has remained localized to the oral cavity and has responded to sublesional corticosteroid injections.(J AM ACAD DZ~_ATOL 1996;34:884-6.)W e report the case of a patient with both pernphigus vulgaris (PV) limited to the oral cavity and ocular cicatricial pemphigoid (OCP).W e believe that this is the first reported case of coexisting OCP and PV. CASE REPORTA 57-year-old woman first had throat irritation and small blisters in her mouth in 1990.Six weeks later, a biopsy sample was obtained from her oral mucosa.Results were inconclusive.Two months later, the patient's voice became hoarse and ulcers developed on her tongue (Figs. 1 and 2).Another biopsy specimen revealed suprabasilar acantholysis with an intraepidermal vesicle.We first examined the patient 4 months after the onset of her mucosal lesions.Erosions and ulcerations of her tongue and of the buccal and labial mucosa were observed.A perilesional biopsy specimen from the lower lip was obtained for direct immunofluorescence studies.lgG was present in the intercellular spaces throughout the epithelium.Indirect immunofluorescence studies on monkey esophagus demonstrated PV antibody at a titer of 1:20.In January 1991 immunoblot analysis on normal