Paraneoplastic pemphigus associated with Castleman’s disease in a 13-year-old boy

Paraneoplastic pemphigus is an autoimmune blistering disease associated with an underlying malignancy. This is a case of a 13-year-old boy initially presenting with isolated oral erosions – managed as a case of pemphigus, who one and a half years later developed toxic epidermal necrolysis like rash, both refractory to treatment. Evaluation for an underlying malignancy revealed a retroperitoneal Castleman’s tumor, following the excision of which there was clinical remission of the oral and skin lesions.