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Updated: May 11, 2026
05:05
Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Bullous pemphigoid with prominent milium formation
Daisuke Tsuruta1, Piotr Brzezinski, Hiroshi Koga
1Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan.
Acta Dermatovenerologica Croatica : ADC
|May 21, 2013
Summary
Milia, small keratinous cysts, can appear in bullous pemphigoid (BP) patients. This case highlights milia formation during BP treatment, suggesting they are not a definitive diagnostic marker.
Area of Science:
- Dermatology
- Immunodermatology
Background:
- Milia are common superficial keratinous cysts.
- Bullous pemphigoid (BP) is an autoimmune blistering disease targeting BP180 and BP230 antigens.
Observation:
- A 55-year-old patient with bullous pemphigoid presented with prominent milia formation.
- Histopathology confirmed subepidermal blisters and eosinophilic infiltration consistent with BP.
- Milia developed on healed BP lesions after treatment with oral prednisolone.
Findings:
- Immunofluorescence and immunoblotting confirmed BP, with antibodies targeting the BP180 NC16a domain.
- The patient was diagnosed with bullous pemphigoid associated with milia.
- Milia were noted to be occasionally present in BP cases.
Implications:
- Milia formation can occur in bullous pemphigoid, particularly during treatment.
- The presence of milia should not be mistaken for other blistering conditions like epidermolysis bullosa acquisita.
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