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Dyshidrosiform Bullous Pemphigoid: Case Reports and Review
1Dermatology, San Diego Family Dermatology, San Diego, USA.
Cureus
|February 18, 2020
Summary
Dyshidrosiform bullous pemphigoid is a rare autoimmune blistering disease presenting on the hands and feet in elderly patients. Early consideration is key, as it can mimic other conditions but responds well to treatment.
Area of Science:
- Dermatology
- Autoimmunology
- Clinical Medicine
Background:
- Bullous pemphigoid (BP) is a common autoimmune blistering disease in the elderly.
- Dyshidrosiform bullous pemphigoid (DBP) is a rare variant characterized by blisters on palms and/or soles.
Observation:
- This study reports two male patients with DBP and reviews 72 previously reported cases.
- DBP predominantly affects women aged 61-94, often presenting with palmar/plantar blisters (97%) and progression to other body sites (77%).
- Hemorrhagic or purpuric lesions were noted in 91% of case reports but only 5% in a larger series.
Findings:
- DBP is often misdiagnosed due to its presentation mimicking other hand/foot blistering conditions.
- Neurologic or psychiatric comorbidities were present in at least 9 DBP patients.
- Systemic corticosteroids, with or without other agents, are effective treatments, leading to improvement in nearly all patients.
Implications:
- Consider DBP in elderly patients with new-onset, recurrent, or recalcitrant palmar/plantar blisters.
- Awareness of DBP's varied presentation is crucial for timely diagnosis and management.
- Further research is needed to clarify the association of hemorrhagic/purpuric lesions with DBP.
