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February 1979

Unusual Subepidermal Bullous Diseases With Immunologic Features of Bullous Pemphigoid

Author Affiliations

From the Department of Dermatology, School of Medicine, State University of New York at Buffalo (Drs Provost, Maize, Ahmed, and Dobson), and the School of Medicine, Boston University (Dr Strauss). Dr Provost is now with Good Samaritan Hospital and Johns Hopkins University, Baltimore. Dr Ahmed is now with UCLA School of Medicine. Dr Strauss is now with the University of Iowa School of Medicine, Iowa City.

Arch Dermatol. 1979;115(2):156-160. doi:10.1001/archderm.1979.04010020002002

Sixty-seven patients with histologic and immunologic features of bullous pemphigoid (BP) were evaluated. Eleven patients had a localized blistering disease that was predominantly confined to one area of the body, most commonly the lower extremities.

Two patients displayed a dapsone-responsive blistering disease that was characterized by a flexural distribution of ten to 20 1-cm or less, intensely pruritic, subepidermal bullae and linear IgA basement membrane zone deposition.

Two patients had a chronic recalcitrant generalized scarring, hyperkeratotic, subepidermal blistering eruption that demonstrated serologic and direct immunofluorescence (IF) findings of BP.

One patient displayed grouped small vesicles surmounted on an erythematous base; the clinical diagnosis was dermatitis herpetiformis, but direct IF examination of the biopsy specimen showed features of BP.

One patient with epidermolysis bullosa acquisita had serologic and direct IF features suggestive of BP.

(Arch Dermatol 115:156-160, 1979)