Esophageal involvement in Bullous pemphigoid: Case report

Area of Science:

• Autoimmune diseases
• Gastroenterology
• Dermatology

Background:

• Bullous pemphigoid is a rare, chronic autoimmune blistering disease primarily affecting the skin in elderly individuals.
• Mucosal involvement occurs in 10-35% of cases, most commonly affecting the oral or ocular mucosa.
• Esophageal bullous pemphigoid is rare (4%), potentially presenting with dysphagia, odynophagia, chest pain, or gastrointestinal bleeding.

Observation:

• A 73-year-old female with bullous pemphigoid and vitamin B12 deficiency anemia underwent esophagogastroduodenoscopy.
• Endoscopic findings revealed two blood-filled bullae in the upper esophagus.
• Linear ulcerations and membrane detachment were noted upon endoscope withdrawal.

Findings:

• The case demonstrates esophageal bullous pemphigoid presenting with significant upper gastrointestinal findings.
• Esophageal bullae can lead to symptoms mimicking other gastrointestinal pathologies.
• Vitamin B12 deficiency anemia was a co-occurring condition in this patient.

Implications:

• Esophageal involvement should be considered in bullous pemphigoid patients presenting with gastrointestinal symptoms or unexplained anemia.
• Early diagnosis and management of esophageal bullous pemphigoid are crucial to prevent complications.
• This case underscores the importance of a multidisciplinary approach in managing complex autoimmune dermatologic conditions.