Author Affiliations: Departments of Dermatology (Ms Johnson and Drs West and Travers), Pharmacology and Toxicology (Dr Travers), and Pediatrics & H. B. Wells Center for Pediatric Research (Dr Travers), and Richard L. Roudebush VA Medical Center (Dr Travers), Indiana University School of Medicine, Indianapolis.
Bullous pemphigoid is an autoimmune disease characterized by subepidermal bullae that can involve nearly any skin surface and primarily affects the elderly. Only in a minority of cases are there known precipitating factors, some of which include vaccinations.1
Report of a Case. An 86-year-old white man with a 5-year history of bullous pemphigoid presented with a flare of disease activity. Until this flare, his disease had been well controlled for approximately 1 year, and he was blister free under treatment with mycophenolate mofetil, 500 mg/d, prednisone, 5 mg/d, and doxycycline, 100 mg/d. He was recently diagnosed as having bladder cancer and began intravesical bacillus Calmette-Guérin (BCG) treatments. New blister development began approximately 1 week after initiating therapy. By the end of the second week, he was experiencing a significant flare and declined further BCG treatment. His prednisone dose was increased to 20 mg/d, and his symptoms rapidly improved by his clinic visit.
Johnson JL, West DA, Travers JB. Worsening of Bullous Pemphigoid Following Bacillus Calmette-Guérin Treatment for Bladder Cancer. JAMA Dermatol. 2013;149(2):248-249. doi:10.1001/2013.jamadermatol.729