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Esophageal Nikolsky's Sign: A Rare Finding in a Patient with Bullous Pemphigoid
Sara Ghoneim1, Aun Shah1, Amy Calderon2
1Department of Internal Medicine, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio, USA.
Abstract:
Bullous pemphigoid (BP) is a chronic relapsing autoimmune blistering disease that typically affects middle-age and elderly patients. It can manifest with varying degrees of mucosal involvement in addition to characteristic skin findings. However, esophageal involvement is very rare. We report a case of a 57-year-old female with BP who presented with epigastric pain and melena. She underwent an esophagogastroduodenoscopy which induced bullae seen only upon withdrawal of the endoscope. This finding is analogous to the dermatological finding of Nikolsky's sign. Gentle insertion and withdrawal of the endoscope is recommended to reduce the risk of bullae formation and mucosal injury.
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