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Updated: May 10, 2026
12:23
Granulocyte-dependent Autoantibody-induced Skin Blistering
Published on: October 12, 2012
Bullous pemphigoid as pruritus in the elderly: a common presentation
Christiaan V Bakker1, Jorrit B Terra, Hendri H Pas
1Center for Skin Blistering Diseases, Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
JAMA Dermatology
|June 28, 2013
Summary
Bullous pemphigoid can manifest as severe itch without blisters. Early diagnosis requires considering immunopathologic findings for conditions like pruritic nonbullous pemphigoid.
Area of Science:
- Dermatology
- Immunopathology
Background:
- Bullous pemphigoid (BP) is an autoimmune blistering disease.
- Some patients present with itch but no blisters, exhibiting varied skin lesions.
Observation:
- A study included 15 patients with itch but no blisters, confirmed via immunopathologic findings of BP.
- Mean age was 81.7 years; no blistering occurred during a mean 2.2-year follow-up.
- Diagnosis was delayed by a mean of 2.8 years, with symptoms ranging from pruritus sine materia to eczematous, urticarial, papular, or nodular lesions.
Findings:
- Itch without visible skin lesions can be the sole presenting symptom of bullous pemphigoid.
- Heterogeneous clinical presentations, including eczematous and urticarial variants, were observed.
Implications:
- Serologic tests and direct immunofluorescence are crucial for diagnosing itch without blisters.
- The term 'pruritic nonbullous pemphigoid' is proposed for BP with itch and no blisters.
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