Abstract
A 60-year-old white male with no known medical history presented progressive weight loss and rash. Patient reported a 1-month history of erythematous patches and crusted erosions on the trunk, extremities, lips, and genitalia (60% total body surface area). Lesional histopathology revealed acantholysis and subepidermal blistering. Direct immunofluorescence demonstrated both intra- and subepidermal IgG deposition. An underlying malignancy was suspected, and computed tomography of the chest, abdomen, and pelvis was significant for infiltrative soft tissue disease of the mediastinum with compression of the superior vena cava.
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