“…2,25,26 Otherwise, those same symptoms may be signs of a steroid-induced gastroduodenal condition that requires a different treatment regimen than that used for oesophageal pemphigus, which would thus result in the reduction of daily steroids with subsequent recrudescence of skin and mucosal lesions in cases of oesophageal pemphigus. 3 Delayed diagnosis or misinterpretation can be avoided by performing oesophagogastroduodenoscopy in selected cases; in particular in cases presenting a history of pemphigus vulgaris and who report oesophageal symptoms that do not respond to steroids and antacid /antisecretive adjustment. 2,22,27,28 The EGDS should be performed by a skilled endoscopist to avoid any examination-related exacerbation of the oesophageal lesions due to scope-induced positive Nikolsky sign.…”