Derm Dx: Progressive generalized blisters

A 51-year-old patient presents complaining of blisters on his face, scalp, trunk and groin that have been progressing for several months. He is otherwise healthy and is not taking any medications.

A physical exam demonstrates the skin findings pictured. The patient’s oral, ocular and anogenital mucosa are without lesions. An enzyme-linked immunosorbent assay (ELISA) performed on the patient’s serum ...