Bullous Pemphigoid Masquerading as Erythrodermic Psoriasis

Bullous Pemphigoid occurs more commonly in the elderly with a rare occurrence in infancy, childhood and adolescence. The uniqueness of this presentation in the adolescents warrants this report. Both Erythrodermic Psoriasis and Bullous Pemphigoid are autoimmune skin disorders that differ in presentation though some of the symptoms may overlap. While Erythrodermic Psoriasis presents with massive scaling, Bullous Pemphigoid presents with vesiculo-bullous lesions and blisters which heal and keep spreading leaving burn-like areas. Bullous Pemphigoid is the most frequent subepidermal autoimmune bullous skin disease and could have a polymorphic presentation. At presentation there was massive scaling with intense itching however in the course of treatment, vesicles, blisters and bullae became apparent and the histology result was consistent with the diagnosis of Bullous Pemphigoid. Bullous Pemphigoid was therefore masquerading as Erythrodermic Psoriasis.