Nodular Subtype of Bullous Pemphigoid

Area of Science:

• Dermatology
• Immunodermatology

Background:

• Itchy papules and nodules are common dermatological findings.
• The nodular subtype of bullous pemphigoid is a rare differential diagnosis.
• Distinguishing this subtype is crucial for appropriate management.

Observation:

• A case study of a female patient with intensely itchy papules and nodules on her trunk and extremities.
• Clinical presentation included erythematous, excoriated papules and nodules.
• Histopathology revealed prurigo-like lesions.

Findings:

• Immunofluorescence assays were positive for BP180 and BP230 antibodies.
• Diagnosis confirmed as nodular bullous pemphigoid based on clinical, histological, and immunofluorescence data.
• The patient's lesions healed with combination therapy.

Implications:

• Pemphigoid nodularis is a prurigo variant of bullous pemphigoid.
• Histological and immunopathological features are consistent with common bullous pemphigoid.
• This subtype typically lacks the characteristic blistering seen in classic bullous pemphigoid, highlighting the importance of immunofluorescence in diagnosis.