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November 1990

Pemphigoid Nodularis

Author Affiliations

Dermatologic Clinic University Hospital CH-1011 Lausanne, Switzerland

Dermatologic Clinic and Central Laboratory of Pathology Saint-Louis Hospital University of Paris VII 1, av Claude Vellefaux F-75010 Paris, France

Arch Dermatol. 1990;126(11):1522-1523. doi:10.1001/archderm.1990.01670350138032

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

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