A Case of Exfoliative Esophagitis with Pemphigus Vulgaris

We describe our experience with a 44-year-old man who presented with hematemesis and sudden-onset chest pain. His past medical history was of pemphigus vulgaris of 3 years’ duration. Large white membranes were pulled out perorally forming approximate 8-cm-long tubes, which were highly suspicious of shredded whitish membranes detaching from the underlying intact mucosa of esophagus. Emergency endoscopic findings confirmed the presence of severe erosions and bleeding in the lower tubular esophagus according with the exfoliative membranes. The patient received a diagnosis of exfoliative esophagitis with pemphigus vulgaris. Exfoliative esophagitis with pemphigus vulgaris is a rare disease with low prevalence. Surgical resection of the esophagus should be considered once upper gastrointestinal bleeding is not well-controlled. Our understanding of exfoliative esophagitis with pemphigus vulgaris remains largely limited, and further studies should be needed to explore the exact molecular mechanisms.