Bullous pemphigoid of idiopathic origin
Keywords:
bullous pemphigoid, idiopathic, skin, infection.Abstract
Introduction: Bullous pemphigoid is a subepidermal autoimmune bullous vesicular dermatosis associated with the formation of autoantibodies that confirm autoantigens in the basement membrane area. Immunomodulatory treatment with corticosteroids is the first line in the control of the disease.Objective: To present the clinical case of a patient diagnosed with a bullous pemphigoid of idiopathic origin.
Clinical case: 81-year-old male patient with blistering lesions that are painful on palpation with serohematic content, varied in size, regular borders and a generalized erythematous base; that the initial evaluation suggests a diagnosis of bullous pemphigoid and active bacterial infection of the skin. Laboratory tests and diagnostic images are requested, infectious, autoimmune or associated neoplastic etiologies are ruled out, treatment with intravenous corticosteroids is started with adequate clinical evolution. Finally, no diseases associated with the patient's blistering lesions were identified.
Conclusion: Bullous pemphigoid is a rare entity, with a high mortality rate if a late diagnosis and treatment is performed. Recognizing the main manifestations and clinical variants of this disease allows for a timely diagnostic and therapeutic approach, the latter based on the control of the inflammatory response against the skin and other organs.
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References
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8. Shah P, Svigos K, Yin L, Soter N, Sicco K, Adotama P. Differences in the clinical presentation of bullous pemphigoid in patients with skin of colour and patients with white skin. Br. J. Dermatol. 2021; 185:430-2. DOI: 10.1111/bjd.20068
9. Holtsche M, Beek N, Künstner A, Busch H, Zillikens D, Schmidt E. Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases. Acta Derm. Venereol. 2021; 101:adv00410. DOI: 10.2340/00015555-3748
10. Seyed S, Feldmeyer L, Bossart S, Simon D, Schlapbach C, Borradori L. Case Report: Combination of Omalizumab and Dupilumab for Recalcitrant Bullous Pemphigoid. Front Immunol. 2021; 11:611549. DOI: 10.3389/fimmu.2020.611549
2. Deotto ML, Spiller A, Sernicola A, Alaibac M. Bullous pemphigoid: An immune disorder related to aging (Review). Exp Ther Med. 2022; 23(1):50. DOI: 10.3892/etm.2021.10972
3. Moro F, Fania L, Sinagra JLM, Salemme A, Di Zenzo G. Bullous Pemphigoid: Trigger and Predisposing Factors. Biomolecules. 2020; 10(10):1432. DOI: 10.3390/biom10101432
4. Pratasava V, Sahni VN, Suresh A, Huang S, Are A, Hsu S, et al. Bullous Pemphigoid and Other Pemphigoid Dermatoses. Medicina (Kaunas). 2021; 57(10):1061. DOI: 10.3390/medicina57101061
5. Messingham KN, Holahan HM, Frydman AS, Fullenkamp C, Srikantha R, Fairley JA. Human eosinophils express the high affinity IgE receptor, FcεRI, in bullous pemphigoid. PLoS One. 2014; 9(9):e107725. DOI: 10.1371/journal.pone.0107725
6. Chen X, Zhao W, Jin H, Li L. Risk Factors for Mucosal Involvement in Bullous Pemphigoid and the Possible Mechanism: A Review. Front Med (Lausanne). 2021; 8:680871. DOI: 10.3389/fmed.2021.680871
7. Zhou T, Peng B, Geng S. Emerging Biomarkers and Therapeutic Strategies for Refractory Bullous Pemphigoid. Front Immunol. 2021; 12:718073. DOI: 10.3389/fimmu.2021.718073
8. Shah P, Svigos K, Yin L, Soter N, Sicco K, Adotama P. Differences in the clinical presentation of bullous pemphigoid in patients with skin of colour and patients with white skin. Br. J. Dermatol. 2021; 185:430-2. DOI: 10.1111/bjd.20068
9. Holtsche M, Beek N, Künstner A, Busch H, Zillikens D, Schmidt E. Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases. Acta Derm. Venereol. 2021; 101:adv00410. DOI: 10.2340/00015555-3748
10. Seyed S, Feldmeyer L, Bossart S, Simon D, Schlapbach C, Borradori L. Case Report: Combination of Omalizumab and Dupilumab for Recalcitrant Bullous Pemphigoid. Front Immunol. 2021; 11:611549. DOI: 10.3389/fimmu.2020.611549
Published
2023-01-17
How to Cite
1.
Garcia J, Tuta Quintero E, Martinez P, Fierro D, Montealegre C, Pulido C. Bullous pemphigoid of idiopathic origin. Rev Cubana Med Milit [Internet]. 2023 Jan. 17 [cited 2025 Apr. 29];52(1):e02302221. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2221
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