PEMPHIGUS-VULGARIS TRANSFORMING INTO PEMPHIGUS FOLIACEUS AND THEIR COEXISTENCE

We present a case of the transformation of pemphigus vulgaris (PV) int o pemphigus foliaceus (PF), with clinical, histological and Immunologi cal characteristics of the two major forms of the disease. At the begi nning,the patient had oral involvement and cutaneous vegetating lesion s typical of PV. Later, and in addition flaccid bullae with a histolog ical pattern characteristic of PF, in some areas with suprabasal acant holysis characteristic of PV, developed. Intercellular antibodies, stu died repeatedly by immunoblot, recognized both PV (130 kD) and PF (160 kD) antigens. To our knowledge, this is the first case of well-docume nted transition of PV into PF, and their coexistence. This case may be considered sa an ''experiment of nature'', which provides evidence th at the clinical and histological expression of the disease is directly related to the specificity of IC antibodies.