Histologic findings of Hailey-Hailey disease in a patient with bullous pemphigoid

The association of bullous pemphigoid with other immune-mediated diseases has been described; however, coexistence with other bullous dermatoses is unusual. We describe a patient with longstanding localized bullous pemphigoid and the recent finding of a Hailey-Hailey-like histologic pattern in a biopsy specimen obtained at a site of active pemphigoid involvement, as confirmed by immunofluorescence studies. Although this case suggests the possibility of coexistence of two bullous diseases, the Hailey-Hailey-like pattern more likely represents an incidental microscopic finding or a solitary acantholytic lesion.