Strongyloidiasis is caused by the roundworm Strongyloides stercoralis (S. stercoralis). It is uncommon in the Unites States, and most cases are brought by travelers who have visited or lived in South America or Africa. Individuals with an intact immune system may experience mild gastrointestinal symptoms or none at all. In contrast, those with a compromised immune system may develop a rapidly fatal infection, commonly referred to as hyperinfection syndrome or disseminated Strongyloidiasis. We present a 66-year-old inmunocompromised male with Pemphigus Foliaceus who was admitted to the intensive care unit in critical condition and in whom a skin biopsy prove to be the main tool in the diagnosis of Strongyloidiasis.