Bullous pemphigoid on an incision scar of total knee prosthesis

Kavak, Ayşe; Parlak, Ali Haydar; Çetinkaya, Reyhan; Tüzüner, Tolga

doi:10.4103/0019-5154.25219

Cited by 5 publications

(11 citation statements)

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“…Most cases occurred following skin grafting, abdominal surgery and amputation. Two cases similar to our own originated at the surgical site but occurred many months after the procedure 6 7…”

Section: Discussionsupporting

confidence: 64%

“…Bullous pemphigoid (BP) is an autoimmune blistering skin condition with a complex aetiology, consisting of predisposing genetic factors as well as external influences such as medications and viral infections 3–5. There have also been a number of documented cases occurring following physical insults, including trauma and surgical procedures,6–16 with stump pemphigoid following amputation being particularly well recognised 17–19…”

Section: Introductionmentioning

confidence: 99%

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Localised bullous pemphigoid overlying knee arthroplasty: a diagnostic challenge

et al. 2019

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An elderly Caucasian woman developed bullous pemphigoid (BP) overlying the site of total knee arthroplasty for osteoarthritis 2 days after surgery. The clinical findings were consistent with blistering due to soft tissue swelling, bullous impetigo or allergic contact dermatitis. The blistering spread over weeks to months down the ipsilateral leg and then to the other leg and hips. A biopsy for H&E and direct immunofluorescence established the diagnosis of BP. A concomitantly occurring wound infection was identified and treated. The blistering responded well to superpotent topical steroids and local care.

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Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Localised bullous pemphigoid overlying knee arthroplasty: a diagnostic challenge

et al. 2019

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“…One point of view is that the injury may ´uncover´ BP antigens which were previously inaccessible to the immune system (13), or alters these antigens in BMZ, which becomes alien to immune cells (3). If this latter happens, this enhanced antigenicity of the basement membrane constituents leads to ´de novo´ synthesis of autoreactive antibodies.…”

Section: Discussionmentioning

confidence: 99%

“…Types of injury that can lead to BP vary greatly, among them, surgical procedures such as arthroplasty, are infrequently reported (2,3). Some authors attribute this rare form of disease to a novel concept in dermatology, so called "immunocompromised district" (ICD) (4).…”

mentioning

confidence: 99%

Localized Bullous Pemphigoid on the Site of Knee Arthroplasty: A Case Report

Kosi

Perić

Pantović

et al. 2016

Serbian Journal of Dermatology and Venereology

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Localized bullous pemphigoid is a rare variant of bullous pemphigoid, and its exact etiopathogenesis is yet to be elucidated. We present a case of a 74-year-old Caucasian male with a 3-month history of skin lesions that appeared 9 months after he underwent a knee arthroplasty. Dermatological examination showed several pruritic tense bullae on the right knee, localized around the surgical scar, as well as erosions covered with crusts. The diagnosis of localized bullous pemphigoid was confi rmed by direct immunofl uorescence test (conventional and split-skin). The patient was treated with potent topical steroids, which led to complete resolution of cutaneous lesions. We suppose that the occurrence of localized bullous pemphigoid in our patient may be explained by the concept of "immunocompromised district" in which one disease (surgery) caused an immunological alteration which is a predisposing factor for the development of secondary disease such as localized bullous pemphigoid.

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“…[2] PRECIPITATING FACTORS Most cases of BP occur sporadically without any obvious precipitating factors. However, there are several reports of precipitation of BP by ultraviolet (UV) light, either UVB or Psoralen with ultraviolet A (PUVA), [11] radiation therapy, [12] percutaneous endoscopic gastrostomy, [11] thermal burn, [13] amputation stump, [14] incisional hernia scar, [15] and injection or an adhesive dressing. [16] In these cases, BP remained localized to traumatized site or became generalized.…”

Section: Clinical Manifestationsmentioning

confidence: 99%