CONFLICT OF INTEREST: None declared. Koji KAMIYA, 1,2 Eiichi NISHIO, 1 Ai HORIO, 1 Yoshiki TOKURA 2 1 Department of Dermatology, Toyokawa City Hospital, Toyokawa, and 2 Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan doi: 10.1111/1346-8138.13187 REFERENCES 1 Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC. Clinical classification of cases of toxic epidermal necrolysis, Stevens- Johnson syndrome, and erythema multiforme. Arch Dermatol 1993; 129(1): 92–96. 2 Fuccio L, Minardi ME, Zagari RM, Grilli D, Magrini N, Bazzoli F. Meta-analysis: duration of first-line proton-pump inhibitor based triple therapy for Helicobacter pylori eradication. Ann Intern Med 2007; 147: 553–562. 3 Misiewicz JJ, Harris AW, Bardhan KD, Levi S, O’Morain C, Cooper BT, et al. One week triple therapy for Helicobacter pylori: a multicen- tre comparative study. Lansoprazole Helicobacter Study Group. Gut 1997; 41(6): 735–739. 4 Mockenhaupt M, Viboud C, Dunant A, Naldi L, Halevy S, Bouwes Bavinck JN, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: assessment of medication risks with emphasis on recently marketed drugs. The EuroSCAR-study. J Invest Dermatol 2008; 128: 35–44. 5 Garnock-Jones KP. Vonoprazan: first global approval. Drugs 2015; 75(4): 439–443. Blistering disease associated with diffuse large B-cell lymphoma but without autoantibodies Dear Editor, Paraneoplastic pemphigus (PNP), usually associated with hematological malignancy, is characterized clinically by severe mucocutaneous and pulmonary involvement and histopatho- logically by acantholysis and lichenoid tissue reaction. 1 PNP is frequently associated with autoantibodies against desmoglein (Dsg)3, envoplakin and periplakin. 1,2 We report a 68-year-old woman who presented with atypical PNP with oral erosions and cutaneous pustules, and (a) (d) (e) (b) (c) Figure 1. Clinical appearance, histopatho- logical findings and patch testing results. Erythematous macules and coalesced targetoid lesions on (a) the trunk, (b) extending to the face and (c) the proximal lower extremities. (d) Histopathology, showing interface dermatitis (hematoxylin– eosin, original magnification 9400; scale bar, 50 lm). (e) Patch tests, showing a positive reaction to amoxicillin. Correspondence: Sakuhei Fujiwara, M.D., Ph.D., Department of Dermatology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama- machi, Yufu, Oita 879-5593, Japan. Email: fujiwara@oita-u.ac.jp 341 © 2015 Japanese Dermatological Association Letters to the Editor