In 1926, Senear and Usher1 first focused attention on a unique type of pemphigus with clinical overlap features of lupus erythematosus (LE). Based solely on the clinical manifestation, these authors summarized 11 cases of this unique dermatosis—four cases reported by them and seven additional similar cases summarized at the time in the world literature. Most of these cases had been reported at meetings of various dermatologic societies, which resulted in considerable discussion and confusion concerning proper classification of the disease. Nevertheless, the idea of an overlap syndrome was proposed.
The following two distinct clinical features were noted: (1) a facial rash strikingly similar to LE and (2) bullous lesions on the body, particularly on the chest and upper part of the back, that resembled pemphigus. These latter lesions would rupture easily, leaving denuded areas or seborrheiclike crusts and would involute spontaneously, with subsequent hyperpigmentation. In their discussion of the