ABSTRACT
A case of localized bullous pemphigoid that mimicked an acute contact dermatitis around a stoma site is presented. The diagnosis was confirmed by direct immunofluorescence and by indirect immunofluorescence on 1.0 mol/L of sodium chloride split skin. A review of the literature demonstrates 30 previous well-documented cases of localized bullous pemphigoid. As in our case, local factors such as trauma, ultraviolet light, or topical therapy seem to be frequently implicated in the production of lesions. The possibility that these patients might otherwise have subclinical bullous pemphigoid was considered. The disease has a benign course and generally responds to cessation of exacerbating factors and initiation of topical steroid therapy.
Subject(s)
Dermatitis, Contact/diagnosis , Pemphigoid, Bullous/diagnosis , Skin Diseases, Vesiculobullous/diagnosis , Adhesives/adverse effects , Aged , Aged, 80 and over , Colostomy/instrumentation , Complement C3/analysis , Dermatitis, Contact/pathology , Diagnostic Errors , Female , Fluorescent Antibody Technique , Humans , Immunoglobulin G/analysis , Pemphigoid, Bullous/pathologyABSTRACT
Malignant pyoderma is a rapidly progressive ulcerating process of unknown origin that predominantly affects the head and neck of young adults. Malignant pyoderma has been considered distinct from pyoderma gangrenosum because of the predominant head and neck location of the ulcers and because the ulcers lack undermining and surrounding erythema. A case of a 22-year-old woman with a severe ulcerative process predominantly affecting the head and neck is described. A review of the literature indicates that malignant pyoderma and pyoderma gangrenosum are almost certainly identical disorders.
