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Bullous Pemphigoid Causing Successive Emergency Department Visits.

Edmund Hsu1, Andrew T Kinoshita2, C Eric McCoy1

  • 1University of California Irvine, Department of Emergency Medicine, Orange, California.

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|February 14, 2024
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Summary
This summary is machine-generated.

An 84-year-old male experienced severe blistering due to bullous pemphigoid (BP), a rare autoimmune disease. This case highlights the need for specialized dermatology care for persistent bullous pemphigoid symptoms.

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Area of Science:

  • Dermatology
  • Immunopathology
  • Autoimmune Diseases

Background:

  • Bullous pemphigoid (BP) is a rare autoimmune blistering disease affecting older adults.
  • It involves autoantibodies targeting hemidesmosomal proteins, leading to basement membrane destruction and subepithelial bullae.
  • The incidence of BP is increasing, with potential atypical presentations and drug associations.

Purpose of the Study:

  • To present a case of bullous pemphigoid in an 84-year-old male with Fitzpatrick type IV skin.
  • To illustrate the diagnostic and management challenges of bullous pemphigoid.
  • To emphasize the importance of specialized dermatological care for refractory cases.

Main Methods:

  • Case presentation of an elderly male with extensive blistering.
  • Review of bullous pemphigoid pathophysiology and treatment guidelines.
  • Description of clinical course including emergency department visits and hospitalization.

Main Results:

  • The patient presented with widespread blistering on extremities, chest, and back.
  • Initial treatments did not resolve symptoms, necessitating further outpatient dermatology care.
  • The case underscores the potential severity and chronicity of bullous pemphigoid.

Conclusions:

  • Bullous pemphigoid can present with severe, widespread blistering requiring intensive management.
  • Prompt diagnosis and specialized dermatological intervention are crucial for effective treatment.
  • This case highlights the importance of considering bullous pemphigoid in elderly patients with unexplained blistering.