A 22-year-old white man with bilateral CCC was referred to us in October 2000. The patient's medical history was remarkable for a mucocutaneous blistering disease with skin (Figure 1A), nasal, oral (Figure 1B), and anal sores, and bilateral CCC. The symptoms began with skin involvement in October 1998, when the patient noticed blisters on his arms, gluteal area, and left leg. Initial treatment was with systemic antibiotic drugs, but produced no substantial improvement. In September 1999, the patient experienced episodes of nasal bleeding that was difficult to control. The patient underwent sinus surgery, but the procedure was aborted when intraoperative findings revealed extensive mucosal erosions and scarring. After surgery, treatment with systemic prednisone, 35 mg/d, was begun. Despite this therapy, the patient continued to develop blisters, particularly at sites of trauma, including hands, elbows, knees, and ankles. Moreover, the disease progressed to involve both eyes in May 2000, when the patient experienced excruciating eye pain and photophobia that confined him to a dark room at home. His ophthalmologist prescribed dapsone, 100 mg/d, to treat presumed OCP, and 0.1% fluorometholone eyedrops 4 times a day, artificial tears 8 times a day, and a combination of 0.1% dexamethasone–0.3% tobramycin ointment (TobraDex) at bedtime. Two months later, however, the patient developed oral lesions that prevented him from chewing solid food. The dosage of dapsone was increased to 150 mg/d. Despite this regimen, the patient's signs and symptoms continued to worsen.