Synonym(s)
Localized bullous pemphigoid; Localized pretiabial bullous pemphigoid; Localized pretibial bullous pemphigoid
DefinitionThis section has been translated automatically.
Rare localized variant of bullous pemphigoid, especially in older people. It comprises a phase of itching followed by varying degrees of blistering. The pretiabile variant affects about 1% of the total BP population (Chang YT et al. 1996). It was described after application of a PD-1 inhibitor in the therapy of metastatic malignant melanoma (Kyle T el al. 2018).
LocalizationThis section has been translated automatically.
Mainly occurring on lower legs, but also in the neck area. Symmetrical infestation is often present.
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HistologyThis section has been translated automatically.
Subepidermal suprabasal bladder.
Direct ImmunofluorescenceThis section has been translated automatically.
C3, IgM and fibrin at the dermo-epidermal border.
Indirect immunofluorescenceThis section has been translated automatically.
Circulating pemphigoid antibodies are not always detectable. In these cases it can be tried to detect antibodies directly from the bladder contents.
Differential diagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
Systemic therapy is usually not necessary. Short-term external therapy with potent glucocorticoids such as 0.05% Clobetasol ointment (e.g. Dermoxin ointment) or 0.1% Diflucortolone ointment (e.g. Nerisona ointment). Cover with ointment grids and sterile gauze dressings. To avoid superinfection, use moist compresses with antiseptic additives such as quinolinol (e.g. quinosol 1:1000 or R042 ) or potassium permanganate (light pink) if necessary.
LiteratureThis section has been translated automatically.
- Calikoglu E et al (2002) Localized bullous pemphigoid as an unusual complication of radiation therapy. J Eur Acad Dermatol Venereol 16: 646-647
- Chang YT et al (1996) Bullous pemphigoid- a report of 86 cases from Taiwan. Clin Exp Dermatol 21: 20-22
- Fontaine J (2003) Treatment of bullous pemphigoid. J Dermatol 30: 83-90
- Jappe U et al (1999) Guess what! Initially localized bullous pemphigoid at the irradiation site of breast carcinoma. Eur J Dermatol 9: 139-14
- Keyle T et al (2018) Localized pretiabial bullous pemphigoid under pembrolizumab therapy due to metastatic melanoma. J Dtsch Dermatol Ges. 16: 196-198
- Knoell KA et al.Localized bullous pemphigoid following radiotherapy for breast carcinoma. Arch Dermatol 134: 514-515
- Kobayashi TT et al. A case of bullous pemphigoid limited to psoriatic plaques. Cutis 70: 283-287
- Seishima M et al (1999) Antibody to bullous pemphigoid antigen 1 binds to the antigen at perilesional but not uninvolved skin, in localized bullous pemphigoid. Eur J Dermatol 9: 39-42
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Incoming links (1)
Quinolinol sulphate monohydrate solution 0,1 % (nrf 11.127.);Outgoing links (4)
Epidermolysis bullosa acquisita; Glucocorticosteroids; Pemphigoid antibodies; Potassium permanganate;Disclaimer
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.
Prof. Dr. med. Peter Altmeyer