Two cases of dyshidrosiform pemphigoid with different presentations

We report two cases of dyshidrosiform pemphigoid (DP) with different presentations. One patient was a 65-year-old Japanese man, who had been diagnosed with dyshidrosis and had been treated before visiting our hospital. When we stopped all treatments, the vesicles increased and spread to the trunk and limbs. We made a diagnosis of vesicular pemphigoid (VP) that was concomitant with or transformed from DP. Using Western blotting, the sera reacted with antigens with molecular weights of 60 and 180 kDa. The 60-kDa antigen has not been found previously in the sera of patients with VP. The other patient was a 94-year-old Japanese woman, who presented with redness and swelling with bullae on the palmoplantar areas. Five days later, areas of oedematous erythema, as seen in prototypical bullous pemphigoid (BP), developed on the limbs. Study of the distribution of the BP antigen may elucidate the mechanisms involved in localized forms of BP such as DP.