Coexistence of bullous pemphigoid and systemic lupus erythematosus

Abstract

A vesiculobullous eruption with clinical and histological features of bullous pemphigoid developed in a 28-year-old woman with proven systemic lupus erythematosus (SLE). Serum of this patient contained elevated titers of antinuclear antibodies but basement membrane antibodies could not be detected at first, though they did appear in blister fluid. Normal monkey skin explants cultured on this patient's sera gave positive direct immunofluorescence (IF) at the basement membrane zone (BMZ) for IgG deposits. The use of tissue culture methods may be helpful because of the capacity of this test system to reveal the presence of the antibodies to the BMZ despite the presence of the antinuclear antibodies that appear to interfere with their demonstration in standard indirect IF tests.

Cutaneous bullae following acute steroid withdrawal in systemic lupus erythematosus

“…A careful and thorough differential diagnosis must be formulated before assuming that bullae are due to LE. Bullous pemphigoid (BP) could present with lesions similar to those seen in our patient and has been reported in patients with LE (Kumar et al, 1978;Miller, Downham & Chapel, 1978). However, histological and immunological differences would easily distinguish BP.…”

Bullous Systemic Lupus Erythematosus Associated with Esophagitis Dissecans Superficialis

“…The differential diagnosis of blistering eruptions in patients with SLE includes dermatitis herpetiformis [ 5 ], bullous pemphigoid [ 7 , 8 ], epidermolysis bullosa acquisita [ 9 ], and bullous systemic lupus erythematosus [ 10 , 11 ]. Dermatitis herpetiformis [ 12 ] can be differentiated by light microscopy and direct immunofluorescence.…”

Bullous Pemphigoid in a Patient Treated with UVA-1 Phototherapy for Disseminated Morphea

“…BP has been described in association with other dermatological and systemic diseases [22, 23, 24, 25]; however, the coexistence of BP and morphea has, to our knowledge, only been described once in the literature over the past 35 years [26]. There, these two diseases were interestingly enough also associated with subcorneal pustulosis.…”