Management of a pemphigus with IgA and IgG antibodies and coexistent lung cancer

Immunoglobulin A ( I g A ) pemphigus is a clinically distinct variant of pemphigus characterized by intercellular I g A deposition in the epidermis. Recently, an I g A /Immunoglobulin G ( I g G ) subset of pemphigus with I g A and I g G anti‐keratinocyte cell surface antibodies has been described. Both I g A and I g A / I g G pemphigus have been associated with internal malignancies. Above all, monoclonal I g A gammopathy in patients with I g A pemphigus has been reported, and lung cancers in association with I g A / I g G pemphigus have been described. I g A pemphigus can be successfully treated with dapsone, whereas therapeutic management of I g G / I g A pemphigus is not well established yet. We report a rare case of a patient, who developed atypical pemphigus with both I g A and I g G autoantibodies and an underlying lung cancer, successfully treated with corticosteroids and dapsone.