We report two cases of children with bullous pemphigoid. He did not present with any abdominal pain, blood pressure was 179 mm hg and urinary protein. We describe the case of a 75yearold woman who presented with new onset of erythematous and bullous lesions 5 days after receiving. The condition started some eight weeks previously when. Bullous pemphigoid is an acute or chronic autoimmune skin disease, involving the formation of blisters, more appropriately known as bullae, at the space between the skin layers epidermis and dermis. Several variants of bullous pemphigoid have been reported including pemphigoid nodularis. Bullous pemphigoid bp is the most common autoimmune bullous disease affecting the skin and mucosal membranes, with antibodies directed against the 180kda bp antigen bp180 and the 230kda bp antigen bp230 located in the basement membrane zone. Bullous pemphigoid associated with dipeptidyl peptidase.
Bp commonly affects older patients and females are slightly more affected than males. Pemphigoid nodularis rare presentation of bullous pemphigoid. Development of bullous pemphigoid during nivolumab therapy. The features of the present case report are similar to the ones reported in the literature, highlighting the elderly patient group, presenting initial papulonodular pruritic lesions and secondary vesicular bullous lesions or urticarial plaques. Dyshidrosiform bullous pemphigoid is a rare variant of bullous pemphigoid, and it usually presents as itchy, potentially hemorrhagic, or purpuric blisters on the palms andor soles of elderly individuals.
Bullous pemphigoid is an autoimmune blistering condition that usually occurs in elderly individuals. Bullous pemphigoid associated with acquired hemophilia a. There are a number of variants of bullous pemphigoid. Bullous pemphigoid bp is an autoimmune subepidermal dermatosis that generally affects people older than 70 years, with no ethnic, racial or sexual predilection. Mucous membrane pemphigoid in a patient with hypertension. There have been reports of various adverse effects associated with the use of atenolol including bullous pemphigoid. A 42yearold thai man presented to our faculty after developing. A 9yearold boy presented with a 1day history of a palpable purpuric rash on his lower limbs 3 days after a viral illness. The first one was a case of a 4monthold female infant, whereas the second is of a 3monthold male infant. In conclusion, we report a case of bp associated with chronic renal allograft rejection in a young man with renal allograft, the probable triggering factor for the development of the bullous disease. Psychiatric and neurological disorders are associated with. Recent studies report the presence of the bullous pemphigoid antigen, bp180, in melanoma cells, yet not normal melanocytes, suggesting an underlying. Lowdose subcutaneous immunoglobulin is an effective. Pdf on jan 26, 2016, chunbing chen and others published childhood bullous pemphigoida case report find, read and cite all the.
Bullous pemphigoid bp is a autoimmune blistering disease encountered in india. The aim of this case report is to present a classic case of this condition. Dyshidrosiform bullous pemphigoid is a rare variant of bullous. Bullous pemphigoid is an autoimmune blistering disorder that typically presents in elderly patients as pruritic tense subepidermal blisters on the lower trunk, axilla, and groin. Bullous pemphigoid bp has been associated with dipeptidyl peptidase. She also complained of a spreading, pruritic, bullous rash, which rst began three weeks previously. Bullous pemphigoid triggered by swine flu vaccination. Louisville, ky a case is reported in which a patient with longstanding rheumatoid arthritis ra developed bullous pemphigoid bp.
Clinical diagnosis and a shortterm treatment of bullous pemphigoid in an adult yemeni female. Dec 05, 2018 pemphigoid nodularis pn is a rare clinical variant of bullous pemphigoid characterized by the presence of nodular prurigolike lesions and pemphigoid blisters. Three case reports of post immunization and post viral. The ageadjusted incidence of bp has been reported to be on the rise 1,2,3. Case report open access erythrodermic psoriasis with bullous. Nov 22, 2008 mucous membrane pemphigoid mmp is a rare group of chronic autoimmune disorders characterized by blister producing lesions. It is the variant most likely to occur in the oral cavity and eyes.
It is a subepidermal bullous disorder commonly seen in the older generations. A case report erin streu1, marni c wiseman2 and james b johnston3,4 abstract intravenous immunoglobulin is a recognized treatment in recalcitrant autoimmune bullous diseases. One week later, he developed arthralgia in his lower limbs, facial oedema and progression of the rash to his buttocks and lower arms. Bullous pemphigoid bp is an autoimmune subepidermal blistering disorder that results in large tense bullae, which is induced. Bullous pemphigoid bp is a rare autoimmune skin disease with the predilection on the elderly. She had a bullous pemphigoid disease area index bpdai activity score of 50, damage score of 8, and autoimmune bullous skin disorder intensity score absis of 52. It is classified as a type ii hypersensitivity reaction, with the formation of antihemidesmosome antibodies. To the best of our knowledge we present the first case report of atenololinduced mucous membrane pemphigoid.
Localized bullous pemphigoid is a rare variant of bullous pemphigoid, and its exact etiopathogenesis is yet to be elucidated. These medications can induce a variety of cutaneous eruptions, the full spectrum of which is not yet completely characterized. A case of oropharyngeal bullous pemphigoid presenting with. The exact pathophysiology underlying the disorder remains incompletely understood. Mucous membrane pemphigoid has been known by many different names within the medical literature including benign mucous membrane pemphigoid, cicatricial scarring pemphigoid, and ocular cicatricial pemphigoid. A possible case of bullous pemphigoid bp that developed during treatment with ustekinumab is reported. It is most commonly found in the elderly and is diagnosed based on clinical, histologic, and immunologic criteria. Autoimmune disease, bullous pemphigoid, corticosteroids.
It presents clinically with diffuse eczematous, pruritic, urticarialike lesions, with the later appearance of tense bullae or blistering lesions typically filled with clear fluid. Clinical features, outcomes, and risk of bp for new dpp4i linagliptin, saxagliptin, and alopgliptin are not well established. A 15monthold boy presented with recurrent blisters on his face, trunk, and extremities 1 month later after receiving measles. Infusions are administered monthly over 15days in the hospital setting and associated with mild to severe infusionrelated systemic effects, in part. Few studies shows autoimmune bullous diseases associated with human immunodeficiency virus hiv.
Bullous pemphigoid bp is an acquired autoimmune blistering disease characterized by the formation of autoantibodies against hemidesmosomal antigens bp180 and bp230. Bullous pemphigoid is well known for its cutaneous features. Successful management of bullous pemphigoid with dimethyl fumarate therapy. Nov 15, 2016 bullous pemphigoid bp is an autoimmune skin disease with incidence varying between 0. Bullous eruption was easily controlled by systemic corticosteroids and did not recur after graft nephrectomy during a clinical followup of 8 months. It is caused by circulating and tissuebound autoantibodies directed against bullous pemphigoid antigen 1 or bullous pemphigoid antigen 2 or both.
Pdf childhood bullous pemphigoida case report researchgate. We report a case of bullous pemphigoid presenting with haemoptysis, initially presenting to the ear, nose and throat department for investigation. We present a case of a 74yearold caucasian male with a 3month history of skin lesions that appeared 9 months after he underwent a knee arthroplasty. Bullous pemphigoid bp is a common chronic autoimmune subepidermal blistering disease that commonly affects the elderly. We report a case of bp following administration of certain medication. Localized bp is one of the clinical variants of pemphigoid, which comprises three basic entities based on the affected site and disease consequence. Interstitial pneumonia associated with bullous pemphigoid. Case report clinical diagnosis and a shortterm treatment of. Bullous pemphigoid of the oral cavity 2 case reports with.
Case report open access mucous membrane pemphigoid in a. The purpose of this report is to include in the literature a case of bullous pemphigoid which presented initially with oral signs and symptoms. Lung disorders associated with bullous pemphigoid are extremely rare, and, to our knowledge, this is the first report of an immunologically confirmed case of interstitial pneumonia. Case report a case of oropharyngeal bullous pemphigoid. Previous reports have suggested that vaccination can be a trigger for pemphigoid and this report describes the first known case of swine flu triggered bullous pemphigoid. A consensus group of researchers in 20021 determined that mucous membrane pemphigoid was the. He was also suffering from blisters and ulcers on the limbs and chest. Successful management of bullous pemphigoid with dimethyl.
Bullous pemphigoid bp is a blistering skin disorder infrequent in infancy and rarely reported in medical. A case report of bullous pemphigoid associated with a melanoma. Childhood bullous pemphigoid a case report dear editor, bullouspemphigoid bpusuallyaffectsthe elderly,but bpin infancy has also been reported. Here, we report a case of bullous pemphigoid bp, which began shortly after initiating treatment with the pd1 inhibitor nivolumab. For some patients, with long mean duration of symptoms, the correct diagnosis of pn is delayed because the.
We hereby report a case of metronidazole induced bullous pemphigoid bp in a 52yearold male patient suffering from liver abscess following 4 days of drug administration. Bullous pemphigoid bp is an autoimmune subepidermal blistering disease that predominantly affect elderly more than 60 years of age. Bp, including nodular pemphigoid, pemphigoid vege tans, lichen planus pemphigoides and. Pemphigoid nodularis pn is a rare clinical variant of bullous pemphigoid characterized by the presence of nodular prurigolike lesions and pemphigoid blisters. Bullous pemphigoid is the most common of the blistering disorders. It presents as bullous pemphigoid like bullae, and at times can even induce the formation of true bullous pemphigoid lesions. The skin biopsy findings obtained from the patient were consistent with the diagnosis of bullous pemphigoid bp. Cases of druginduced bullous pemphigoid bp have been reported in association with spironolactone, furosemide, chloroquine.
Bullous pemphigoid in a chronic renal allograft rejection. We report the case of a 71yearold woman with pemphigoid nodularis. The diagnosis is confirmed by direct immunofluorescence dif indirect immunofluorescence iif and immunoserology tests. Localized bullous pemphigoid lbp is a specific form of bullous pemphigoid. Pdf abstract bullous pemphigoid is an autoimmune rare disorder occurring both in male and female with more number among females. Aug 29, 2018 bullous pemphigoid bp is an autoimmune blistering skin disorder characterized by diffuse, erythematous and pruritic skin lesions that often begin as papular andor urticarial, before transforming into deeper and tense vesico. Bp with typical histology and direct immunofluorescence studies. Atenolol is commonly used by patients with hypertension, angina pectoris, or myocardial infarction. Case report, infant, bullous pemphigoid, drug therapy, vaccination background bullous pemphigoid bp is an autoimmune blistering skin disorder associated with presence of tissuebound and circulating igg autoantibodies directed against hemidesmosomal proteins, called bp antigen 180 and bp antigen 230 1. Autoimmune bullous diseases are characterized by bullous lesions to the skin and mucous membranes of the oral cavity, nose, eyes, larynx, pharynx, esophagus, and genitals. Case report open access erythrodermic psoriasis with bullous pemphigoid. We report a case of bullous pemphigoid presenting with haemoptysis, initially presenting to the ear, nose and roat department for investigation. A case report of bullous pemphigoid induced by dipeptidyl. Although igg autoantibodies predominate within the plasma and skin of bp patients, some features of the disease cannot be explained solely by iggmediated mechanisms.
Juvenile bullous pemphigoid a case report article pdf available in serbian journal of dermatology and venereology 51 june 20 with 972 reads how we measure reads. Localized bullous pemphigoid on the site of knee arthroplasty. This atypical onset of pn partially explains the diagnosis delay, especially in the absence of obvious clinical signs of bp. Ustekinumab is a human monoclonal antibody found in pathologies such as psoriasis, which works by inhibiting the activity of interleukin12 and interleukin23. Case report an 81yearold man presented with a 2week history of a widespread erythematous rash and blistering at the site of a vaccination. The immunopathogenesis of the disease is attributed to circulating and tissuebound autoantibodies directed against bullous pemphigoid antigen 230 bullous pemphigoid antigen 1 or bullous pemphigoid antigen 180 bullous pemphigoid antigen 2 or both. Bullous pemphigoid is an acute or chronic autoimmune skin disease causing the formation of blisters bullae in the epidermal and dermal junction.79 923 760 755 707 413 767 619 433 1354 37 564 36 834 707 122 534 120 35 716 638 378 500 871 1150 855 440 43 1039 366 1269 759 1247