Pemphigus following hepatitis B vaccination--coincidence or causality?

Pemphigus is an autoimmune blistering disease caused by autoantibodies against epithelial intercellular components. Its etiology is unknown, and neoplasms, antecedent infections or medications are considered possible triggering factors for the disease in some cases. We describe the first case of pemphigus following a hepatitis B virus vaccination. We suggest that in some cases vaccination may be the triggering factor for pemphigus in genetically predisposed individuals and physicians should be aware of this possible association.