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Related Experiment Video

Updated: Oct 2, 2025

Granulocyte-dependent Autoantibody-induced Skin Blistering
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Split Skin Grafting Precipitated Bullous Pemphigoid.

K Gohil1,2, A Moore1,2, W Jaffe1,2

  • 1Plastic Surgery Department, Royal Stoke University Hospital, Newcastle Road Stoke-on-Trent, ST4 6QG, UK.

JPRAS Open
|February 24, 2022
PubMed
Summary

Bullous pemphigoid (BP), an autoimmune blistering disease, can rarely be triggered by autologous skin grafting. Prompt diagnosis and treatment are crucial to minimize graft loss and ensure optimal patient outcomes.

Keywords:
autoimmune diseasedermatopathologyplastic surgeryskin grafting

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Area of Science:

  • Dermatology
  • Autoimmune Diseases
  • Surgical Complications

Background:

  • Bullous pemphigoid (BP) is an autoimmune subepidermal blistering condition.
  • External factors can trigger BP, but surgical complications are uncommon.

Observation:

  • An immunocompetent patient without prior dermatological history developed BP post-autologous skin graft surgery.
  • Bullae appeared one month after surgery at graft sites and became widespread.
  • Diagnosis was confirmed via histology, direct, and indirect immunofluorescence for anti-skin antibodies.

Findings:

  • Initial topical treatments and wound care were insufficient.
  • Systemic steroids led to a presumed graft infection, necessitating admission.
  • A combined topical and systemic treatment plan was initiated post-histological confirmation.

Implications:

  • Skin grafting can be a rare trigger for bullous pemphigoid, even without prior history.
  • Early recognition and prompt treatment of BP post-surgery are vital for graft survival.
  • Multimodal treatment strategies improve recovery and minimize graft loss in such cases.