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2013, Number 1

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Dermatología Cosmética, Médica y Quirúrgica 2013; 11 (1)

Atypical Bullous Pemphigoid: Report of Three Cases

Riganti J, Franco M, Vaglio GG, Valeria PM, Baztán PMC, Inés VV, Galimberti RL

Language: Spanish
References: 40
Page: 29-34
PDF size: 216.98 Kb.


ABSTRACT

Background: Bullous Pemphigoid (BP) is the most common autoimmune blistering disease of the skin. As cutaneous manifestations of BP are very polymorphic and several atypical variants have been described, the disorder often presents a major diagnostic challenge.
Methods: This paper describes three atypical cases of BP: a) 62-year-old female presenting with a tense blister that contains clear exudate and is circumscribed to the presternal area, as well as a painful mucosal erosion, 2 cm in diamater, involving the left labium minus. b) 88-year-old female with a 4-month history of generalized exfoliative erythroderma who developed tense blisters on erythematous plaques spread over lower extremities. c) 62-year-old male with multiple tense pruritic vesicles restricted to face and dorsum of the hands.
Results: In all cases, histological findings reported subepidermal blisters with dermal eosinophil infiltration. Direct immunofluorescence showed linear deposits of IgG and C3 along the epidermal basal layer, confirming diagnostic.
Conclusions: Three patients with atypical variants of BP are reported, one presenting with vulvar involvement and two others with widespread BP in vesicular and erythrodermic forms. This paper emphasizes the importance of direct immunofluorescence as a diagnostic tool.


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