Dyshidrotic Bullous Pemphigoid: Case Report and Review of Literature

Abstract

DP is an unusual form of localized BP. While the pathogenesis is still unclear, it may involve differential expression of BP antigens in the cutaneous basement membrane of the hands and feet. The clinical presentation is a diagnostic challenge, and skin biopsies with immunofluorescence studies are required for diagnosis.

Deiminated proteins in extracellular vesicles and serum of llama (Lama glama)—Novel insights into camelid immunity

“…Dystonin is a plakin-family adhesion junction plaque protein and was here identified as deiminated in both llama serum and EVs. Dystonin, along with XVII collagen, form hemidesmosomes and both proteins are autoantigens believed to be responsible for the Type II hypersensitivy pathologic in the pruritic skin disease bullous pemphigoid (Bağcı et al, 2017;Basseri et al, 2018). Dystonin has also been linked to Sjögren's syndrome and linked to a hypermethylation status (Gonzalez et al, 2011), but post-translational deimination of dystonin has not been previously described to our knowledge, although deimination is associated with a range of autoimmune diseases, including Sjögren's syndrome (Konsta et al, 2014;Selmi et al, 2015).…”

Dyshidrosiform Bullous Pemphigoid: Case Reports and Review

“…In fact, the clinical differential diagnosis not only includes dyshidrosis or pompholyx, but also allergic and irritant contact dermatitis, chronic bullous disease of childhood, cutaneous T-cell lymphoma (vesicular palmoplantar variant), dermatophyte infection (bullous), epidermolysis bullosa acquisita, erythema multiforme, herpes gestationis, lichen planus (bullous), linear IgA disease, scabies, and systemic contact dermatitis. The possibility of an autoimmune bullous disease is usually not entertained, particularly in individuals for whom the lesions are restricted to the palms or soles or both [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”

“…Most of the reports (24 papers) only described a single patient. However, there were two reports with two patients, four reports with three patients, one report with four patients, one report with nine patients, and one report with 20 patients (one of whom was previously described) [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Also, three larger studies of dyshidrosiform bullous pemphigoid have been performed [17][18][19].…”

“…The onset age of dyshidrosiform bullous pemphigoid ranged from 20 years to 94 years (median: 76 years); however, only three of the patients were in their twenties. The age of the other 35 individuals ranged from 61 to 94 years [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Dyshidrosiform bullous pemphigoid was only slightly more common in women (20 patients) than men (18 patients).…”

“…Unusual clinical variants of bullous pemphigoid have been observed in literature [1][2][3]. Dyshidrosiform bullous pemphigoid refers to the condition when the blisters are initially or persistently localized to the palms and soles [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. In our study, we report the features of two men with dyshidrosiform bullous pemphigoid and review the characteristics of individuals with this rare subtype of bullous pemphigoid.…”