Paraneoplastic pemphigus and myasthenia gravis: A rare duo of paraneoplastic manifestations secondary to thymoma

This case is reported because of the very rare combination of paraneoplastic pemphigus and myasthenia gravis as paraneoplastic manifestations secondary to thymoma. A case of a 37 year old male who presented with skin lesions initially as papules in the face and thighs that evolved into blisters and became widespread, leaving crusted and hyperpigmented patches and plaques. It was associated with cough, dyspnea, ptotis, dysphagia, dysphonia and facial asymmetry. Histopathology and direct immunofluorescence were consistent with paraneoplastic pemphigus. Anticholinerase test confirmed the diagnosis of myasthenia gravis and histologic finidngs of the anterior mediastinal mass confirmed it as thymoma.