Esophageal dissecans: a rare life-threatening presentation of recurrent pemphigus vulgaris.

Esophagitis dissecans superficialis (EDS) is a rare condition characterized by sloughing of the mucosal layer of the esophageal lining, usually triggered by an environmental/immune insult. It is associated with blistering diseases such as pemphigus vulgaris (PV), bullous pemphigoid, and epidermolysis bullosa. Oral mucosa is the most commonly (50%) affected site in PV, but esophageal involvement has only been rarely reported. The most common presentation of EDS includes dysphagia and odynophagia, but overt gastrointestinal bleeding is a distinctly uncommon. We present a unique case of EDS presenting with melena in which diagnostic endoscopy enabled to diagnose and establish link with patient's remote history of PV. Early suspicion and identification of this treatable condition can reduce morbidity and mortality in these patient populations by decreasing severity and recurrence of bleeding.