ABSTRACT
Bullous pemphigoid is a chronic autoimmune blistering disease characterized clinically by tense bullae that develop on normal or erythematous skin. Bullous pemphigoid is associated with autoantibodies to two hemidesmosomal proteins, BPAG1 (230 kD) and BPAG2 (180 kD). The localized form of BP is an unusual variant that occurs in 5~30% of the patients. A 58-year-old man who had been suffering from right hemiplegia since 2006, presented with multiple tense bullae localized on both arms and hands. Direct immunofluorescence test showed linear deposition of IgG and C3 along the basement membrane zone. The antibodies against the recombinant NC16a-domain of BP180 were positive by ELISA and immunoblotting using epidermal extract of normal human foreskin demonstrated that the patient's serum reacted with only BP180 antigen. Here, we report a case of localized bullous pemphigoid on both upper extremities in a hemiplegic patient predominantly on the opposite side to the hemiplegia.
Subject(s)
Humans , Middle Aged , Antibodies , Arm , Autoantibodies , Autoantigens , Basement Membrane , Blister , Enzyme-Linked Immunosorbent Assay , Fluorescent Antibody Technique, Direct , Foreskin , Hand , Hemiplegia , Immunoblotting , Immunoglobulin G , Non-Fibrillar Collagens , Pemphigoid, Bullous , Proteins , Skin , Stress, Psychological , Transcutaneous Electric Nerve Stimulation , Upper ExtremityABSTRACT
A 60-year-old man presented with a 3-week history of pruritic bullae and erosions located within an acupuncture site on the right lower leg. Ten days prior to the development of these bullae, he had been treated with acupuncture to the right calf due to Achilles tendonitis which had developed 1 year earlier. The diagnosis of bullous pemphigoid was confirmed by histologic findings and salt-split direct immunofluorescence study performed on the perilesional skin. To our knowledge, this is the first case of localized bullous pemphigoid following acupuncture.
Subject(s)
Male , HumansABSTRACT
Bullous pemphigoid (BP) is a chronic autoimmune subepidermal blistering disease that usually occurs in the elderly. Two types of clinical variants exist. The generalized form typically involves the lower abdomen, groin, thighs and inner arms. The localized forms of BP include (1) mucous membrane pemphigoid or cicatrical pemphigoid, (2) localized scarring pemphigoid or Brunsting-Perry pemphigoid, and (3) localized nonscarring pemphigoid. We report here on a case of localized nonscarring pemphigoid on the face of a 71-years-old man.
Subject(s)
Aged , Humans , Abdomen , Arm , Blister , Cicatrix , Groin , Mucous Membrane , Pemphigoid, Bullous , ThighABSTRACT
Several clinical variants of bullous pemphigoid have been described (e.g. generalized, vesicular, nodular, polymorphic, vegetans, and localized). Dyshidrosiform pemphigoid is an unusual form of the localized variant of bullous pemphigoid, and was first described in 1979. It presents with a localized, persistent, vesicobullous eruption similar to dyshidrosiform dermatitis. Herein, we report a case of dyshidrosiform pemphigoid which presented with bullae localized to both the palms and soles.