Although this has not been reported in a review of published case reports of pemphigoid vegetans,9 the clinical appearance of our case mirrors case reports of ungual pemphigus vegetans.2, 3, 4, 5, 6 This suggests a common reaction pattern of the nail unit to anti-desmoglein or anti-BP230 autoantibody-mediated eosinophilic spongiotic inflammation and onychocyte discohesion. The gene discussed is DST; the disease is pemphigus vegetans.