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Related Concept Videos

Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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Peptic Ulcer Disease I: Introduction01:30

Peptic Ulcer Disease I: Introduction

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Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Esophageal Varices-I: Introduction01:24

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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors01:24

Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors

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Peptic ulcer disease, commonly called PUD, represents a multifaceted condition characterized by disruptions in the lining of the gastrointestinal (GI)  tract. Central to the protection of the gastrointestinal lining is the mucosal-bicarbonate barrier. This physiological defense mechanism is a formidable shield against the corrosive effects of gastric acid and pepsin secretion in the stomach. Its role is pivotal in maintaining the structural integrity of the stomach's inner lining.
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Related Experiment Video

Updated: Oct 1, 2025

Granulocyte-dependent Autoantibody-induced Skin Blistering
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Esophageal Bullous Pemphigoid.

Catarina Castelo Branco1, Tomás Fonseca1, Ricardo Marcos-Pinto2

  • 1Department of Internal Medicine, Centro Hospitalar Universitário do Porto, Porto, Portugal.

European Journal of Case Reports in Internal Medicine
|March 10, 2022
PubMed
Summary

Bullous pemphigoid, a rare autoimmune skin disease, can affect the esophagus, causing severe gastrointestinal bleeding. Early diagnosis and evaluation of mucous membrane lesions are crucial for better patient outcomes.

Keywords:
Bullous pemphigoiddementiaesophagus

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Area of Science:

  • Dermatology
  • Gastroenterology
  • Autoimmune Diseases

Background:

  • Bullous pemphigoid (BP) is a rare autoimmune blistering disease predominantly affecting the elderly.
  • Mucous membrane involvement occurs in 10-35% of BP patients, typically limited to the oral mucosa.
  • Esophageal BP is exceptionally rare, presenting with symptoms like dysphagia or odynophagia, or sometimes asymptomatically.

Purpose of the Study:

  • To highlight the critical importance of recognizing esophageal involvement in bullous pemphigoid.
  • To emphasize the potential for severe gastrointestinal complications, including bleeding, from esophageal BP.
  • To underscore the need for a high index of suspicion for esophageal lesions in BP patients.

Main Methods:

  • Case report of a 76-year-old male with newly diagnosed bullous pemphigoid.
  • Presentation included typical cutaneous manifestations and severe gastrointestinal bleeding.
  • Diagnostic workup focused on identifying the cause of bleeding and extent of mucosal involvement.

Main Results:

  • The patient presented with significant esophageal involvement leading to severe gastrointestinal bleeding.
  • This case illustrates that bullous pemphigoid, while primarily a skin condition, can have life-threatening gastrointestinal manifestations.
  • Prompt recognition and management are vital, as severe cases may have a poor prognosis.

Conclusions:

  • Bullous pemphigoid requires high suspicion in elderly patients with pruritic skin lesions.
  • Evaluation of mucous membrane lesions is essential due to their association with poorer prognosis, even if asymptomatic.
  • Early diagnosis is paramount, as standard treatments like steroids may be less effective in severe or complicated cases.