Paraneoplastic pemphigus is an autoimmune acantholytic mucocutaneous disorder that rarely accompanies an overt or occult neoplasm. Typical features include painful mucosal erosive lesions and pruritic papulosquamous eruptions that often progress to blisters. The antibody is a unique immunoglobulin G that recognises epidermal proteins. We discuss the case of a 23-year-old woman who presented with anaplastic large cell lymphoma complicated by paraneoplastic pemphigus, rapidly resulting in fatal multiorgan failure.

A 23-year-old woman presented with 1 week of fever and a disseminated erythrodermic rash with desquamation of the hands and feet, and erosions in the mouth. A local doctor started treatment with ciprofloxacin and prednisolone.

A diagnosis of toxic epidermal necrolysis was made. On day 4, she required intubation, ventilation and transfer to a tertiary referral centre. …