18th July 2023

A 65-year-old woman is admitted under the medical team with a 2-month history of intermittent painful oral blisters

A 65-year-old woman is admitted under the medical team with a 2-month history of intermittent painful oral blisters. In the last few days, these have progressed into widespread mucocutaneous blisters affecting the torso, limbs, and oral mucosa. She is normally fit and well and does not take any regular or over-the-counter medications. On examination, she has extensive areas of painful, eroded skin with some bullae present. These bullae burst on minimal contact leaving eroded skin underneath. She has no lymphadenopathy and is apyrexial. Histology of the lesions demonstrates intraepidermal blisters with acantholysis. The appearance was reported as resembling a ‘row of tombstones’.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.