The role of computed tomography and sonography in acute bullous pemphigoid

We report acute bullous pemphigoid occurring in an elderly female patient in whom abdominal sonography and computed tomography (CT) examinations revealed the presence of occult hepatic and splenic metastatic deposits from a primary pancreatic carcinoma. In the majority of cases bullous pemphigoid is a self limiting auto-immune disorder occurring in the absence of systemic disease. An association with visceral malignancy has been described by previous authors but the role of computed tomography and sonography in diagnosing occult malignancy and the subgroup of patients with pemphigoid in whom this should be undertaken has not been highlighted.