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June 1991

Brunsting-Perry Cicatricial Pemphigoid Precipitated by Trauma

Author Affiliations

State University of New York Health Science Center at Brooklyn 450 Clarkson Ave, Box 46 Brooklyn, NY 11203

Arch Dermatol. 1991;127(6):911-912. doi:10.1001/archderm.1991.01680050157028

To the Editor.—  A 78-year-old Hispanic man was without previous skin lesions until he sustained a hot oil burn to his left cheek. He was seen in the emergency department at the Brooklyn (NY) Veterans Administration Medical Center, noted to have a small crusted lesion on the left cheek, diagnosed as having a second-degree thermal burn, and treated with topical silver sulfadiazine cream. When seen in the dermatology clinic 1 week later, his lesions were resolving and showed only crusts on an erythematous base with slight scarring. No further care was recommended. One week later, he returned to the clinic with multiple small, tense blisters in a ring around the previously involved area (Fig 1). Tzanck preparation and herpes simplex cultures were negative.Histopathologic findings revealed a subepidermal blister and superficial perivascular lymphohistiocytic infiltrate with multiple eosinophils (Fig 2). Direct immunofluorescence showed heavy fibrillar deposits of IgG at the dermoepidermal