Esophageal involvement in Bullous pemphigoid: Case report

Bullous pemphigoid is a rare chronic autoimmune dermatologic blistering disease that usually affects elderly patients. Mucosal lesions are present in about 10%-35% of cases and affects most frequently the mucous membranes of the eye or the mouth. Esophageal involvement is possible but is rare (4% of cases). It could be asymptomatic, or presents with dysphagia, odynophagia, chest pain, or upper gastro-intestinal bleeding. We report the case of a recently diagnosed bullous pemphigoid in a 73-years-old female with normochromic normocytic anemia due to vitamin B12 deficiency who was referred to our unity for esophagogastroduodenoscopy. Our endoscopic examination revealed two bullae filled with blood at upper esophagus with linear ulcerations and membrane detachment upon withdrawal of the endoscope. Although bullous pemphigoid is mainly a skin disease, invasion of esophagus needs to be considered especially when symptoms are present or when no cause was found for blood loss or anemia.