Combined bullous pemphigoid and pemphigus vulgaris in an 18-year-old female.

We present a case of an 18-year-old female with clinical, histological and immunopathological features of overlapping pemphigus vulgaris and bullous pemphigoid. This case is unique both in the context of the distinctive hybrid nature of the bullous disorder and the young age of onset. An initial biopsy showed a combined pemphigus pattern histologically and a dominant pemphigoid pattern by immunofluorescence, hence posing a diagnostic conundrum. A subsequent biopsy however confirmed a combined pemphigus and pemphigoid pattern both in the context of the light microscopic findings and by immunofluorescence. The pathophysiologic basis of this distinctive hybrid dermatosis along with the other reported cases of overlapping pemphigus and pemphigoid are reviewed.