Oral erosions and cutaneous bullae

Todd R. Gleaves, BS, Jennifer Clay Cather, MD, and Alan Menter, MD 

A 48-year-old man was referred from Baylor College of Dentistry for evaluation of a 2-month history of large, flaccid, superficial bullae/erosions in the mouth, including the tongue, with subsequent development of blisters on the skin. Examination revealed shallow erosions on his oral mucosa as well as discrete clusters of herpetiform lesions on his lower back. He was in good general health otherwise, with no new medications and no family history of similar lesions. A skin biopsy was performed.

What is your diagnosis? What treatment options exist?