Bullous Pemphigoid. Presented by Irving D. Ehrenfeld, MD.
The patient, a 73-year-old woman, first became aware of blisters on her left breast four months ago.There are several bullae on a non-erythematous base overlying the lower half of the areola and extending to the adjacent skin of the left breast. Histopathologic examination was interpreted as showing "bullous pemphigoid."Neither topical application of 0.5% triamcinolone acetonide cream nor intralesional injection of triamcinolone has had any effect. Grenz ray therapy (200 rads) has been given five times at weekly intervals without any noticeable response.
Samuel B. Frank, MD: I think that this is a case of cicatricial pemphigoid. Indirect immunofluorescent studies can help differentiate the two processes in that results of such studies usually are abnormal in bullous pemphigoid and are normal in cicatricial pemphigoid.Harvey J. Cohen, MD: There is atrophic scarring in the involved site, further supporting the diagnosis
Cohen HJ. THE DERMATOLOGIC SOCIETY OF GREATER NEW YORK. Arch Dermatol. 1972;105(4):613-614. doi:10.1001/archderm.1972.01620070079033