A 77-year-old man presented with a 6-month history of thick, oozing, foul-smelling skin lesions in the groins and around the umbilicus and erosions on the lips. Immunofluorescence of perilesional skin was consistent with pemphigus vegetans, a subtype of the blistering disease pemphigus vulgaris. The lesions went into remission with rituximab in combination with Dapsone and low-dose prednisone.