To the Editor.—
Pemphigoid nodularis is considered a rare variant of bullous pemphigoid.1,2 We describe a white woman with a highly pruritic papulonodular eruption, suggesting initially prurigo nodularis, while the immunopathological features were surprisingly compatible with bullous pemphigoid. Subsequently, blister formation occurred.
Report of a Case.—
An 83-year-old previously healthy woman had an 8-month history of widespread pruritic papular and nodular lesions involving predominantly her legs, arms, thighs, and back, with a few lesions on the abdomen, breast, and scalp. The papulonodular lesions, up to 2 cm in diameter, were in part hyperkeratotic with excoriated surfaces secondary to persistent scratching and they arose on hyperpigmented bases (Fig 1). No blisters were observed. Mucous membranes were clear. She had been treated by her dermatologist with various topical corticosteroids, oral dexchlorpheniramine, hydroxyzine, and terfenadine with no success. A skin biopsy specimen of a papular lesion showed subepidermal vesicles filled with serous
Borradori L, Rybojad M, Verola O, Flageul B, Puissant A, Morel P. Pemphigoid Nodularis. Arch Dermatol. 1990;126(11):1522-1523. doi:10.1001/archderm.1990.01670350138032