[A case of dyshidrosiform pemphigoid].

Area of Science:

• Dermatology
• Immunology

Background:

• Bullous pemphigoid is a chronic autoimmune blistering disease.
• Dyshidrosiform pemphigoid is a rare subtype presenting with vesicles and bullae on hands and feet.

Observation:

• An 85-year-old Japanese male presented with worsening bullae and erosions on hands and feet.
• Clinical examination revealed hemorrhagic pompholyx-like lesions.
• Elevated serum anti-BP180 antibody index (>150) was noted.

Findings:

• Histopathology showed subepidermal bullae with inflammatory infiltrate including eosinophils and neutrophils.
• Direct immunofluorescence revealed strong C3 and weak IgG deposition at the epidermal basement membrane.
• The patient was diagnosed with dyshidrosiform pemphigoid based on clinical and immunopathological findings.

Implications:

• This case underscores the importance of recognizing the distinct clinical presentation of dyshidrosiform pemphigoid.
• Prompt diagnosis and appropriate management are essential for patient outcomes.
• The condition can have severe systemic implications, as suggested by the patient's eventual outcome.