Pediatric Bullous Pemphigoid Induced by Rivaroxaban: A Rare Case Report With Underlying Hereditary Hypercoagulability

Bullous pemphigoid (BP) is a rare autoimmune blistering disorder in pediatric patients. Although various medications have been implicated as potential triggers, hypersensitivity reactions associated with Rivaroxaban, a direct Factor Xa inhibitor, are rarely documented. We present a case of an 8-year-old male who developed widespread BP after 3 months of Rivaroxaban therapy. Histopathological and immunofluorescence findings confirmed the diagnosis. Discontinuation of Rivaroxaban and administration of systemic corticosteroids led to rapid clinical improvement. This case highlights Rivaroxaban-induced BP as a potential adverse reaction in children and underscores the need for awareness and prompt management of this rare but treatable condition.