Bullous Scabies Simulating Pemphigoid

2011 ◽  
Vol 15 (1) ◽  
pp. 55-57 ◽  
Author(s):  
T. Roxana Stan ◽  
Stefano Piaserico ◽  
Matteo Bordignon ◽  
Roberto Salmaso ◽  
Edoardo Zattra ◽  
...  
Keyword(s):  
Skin Lesion ◽  
Bullous Pemphigoid ◽  
Steroid Treatment ◽  
Social Conditions ◽  
Direct Immunofluorescence ◽  
Benzyl Benzoate ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease ◽  
Skin Specimen ◽  
Desmoglein 3

Background: Scabies is a contagious infestation affecting subjects of all ages, races, and social conditions. Objective: We report a case of a 79-year-old man who developed a bullous pemphigoid-like eruption. He presented to our unit 4 months after the onset of symptoms. An autoimmune bullous disease was suspected. Direct immunofluorescence on a skin specimen and anti-desmoglein 1, anti-desmoglein 3, and anti-bullous pemphigoid antigen 180 were negative. Surprisingly, the histology of a skin lesion demonstrated the presence of scabies, which was successfully treated with benzyl benzoate 20%. Conclusion: The diagnosis of bullous scabies should be considered for any bullous eruptions accompanied by papules and itching resistant to steroid treatment and with negative immunopathologic findings.

scholarly journals Assessing the Correlation Between Autoimmune Bullous Disease Quality of Life Questionnaires (ABQOL, TABQOL, DLQI) and Disease Severity Indices in Pemphigus and Bullous Pemphigoid

2020 ◽  
Author(s):  
Shan Cao ◽  
Lulu Sun ◽  
Zhongxiang Shi ◽  
Baoqi Yang ◽  
Furen Zhang
Keyword(s):  
Quality Of Life ◽  
Disease Severity ◽  
Bullous Pemphigoid ◽  
Strong Correlations ◽  
Disease Area ◽  
Area Index ◽  
Severity Of Disease ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease

Abstract Background: Pemphigus and bullous pemphigoid (BP) are autoimmune blistering diseases (AIBDs) that affect the skin and mucous membranes, and adversely impact quality of life (QOL). Few studies have assessed the correlation between the severity of disease and QOL in patients with pemphigus and BP. Objectives: To identify the correlation between the severity of AIBDs and QOL using the Autoimmune Bullous Disease Quality of Life (ABQOL), Treatment Autoimmune Bullous Disease Quality of Life (TABQOL), and Dermatology Life Quality Index (DLQI) questionnaires in Chinese patients with pemphigus and BP at baseline, and after 1, 3 and 6 months of treatment. Methods: Pemphigus and BP patients were invited to complete the ABQOL, TABQOL, and DLQI questionnaires. We measured the pemphigus disease area index (PDAI), autoimmune bullous skin disorder intensity score (ABSIS), and antibodies of desmoglein1,desmoglein3 (DSG1/DSG3) for pemphigus; and the bullous pemphigoid disease area index (BPDAI), ABSIS, and antibodies of BP180/ BP230 for BP as disease severity indices. The correlations between the severity of disease and QOL were analyzed by Spearman’s correlation coefficient (r). Results: Eighty-five patients were included: 55 with pemphigus and 30 with BP. The pemphigus subtypes included pemphigus vulgaris (PV, n = 32), pemphigus foliaceus (PF, n = 22), and paraneoplastic pemphigus (PNP, n = 1). We found significantly strong correlations between QOL (ABQOL, TABQOL, DLQI) and severity of disease (PDAI/BPDAI, ABSIS) with (r = 0.87, 0.77, 0.83; r = 0.86, 0.73, 0.80) for pemphigus and BP, respectively. Mild or strong correlations were also observed between QOL and antibody titers in pemphigus with DSG1/DSG3(r=0.32/0.36) and BP with BP180/BP230( r = 0.73/0.17) respectively. Conclusion: The QOL of patients with pemphigus and BP decreased with increased severity of the AIBDs. As the disease severity descended, so the QOL improved. The QOL indices should be used in clinical trials and to manage patients’ treatment, especially during the active disease stage, despite the mild correlation observed after 1 month of treatment.The PDAI to be better at assessing disease severity than the ABSIS in patients with pemphigus, and ABSIS are better than BPDAI in BP patients for correlation with the QOL indices.

scholarly journals IgA Pemphigus in a Child – a Case Report

2017 ◽  
Vol 9 (1) ◽  
pp. 14-21
Author(s):  
Branislav Lekić ◽  
Mirjana Gajić-Veljić ◽  
Svetlana Popadić ◽  
Miloš Nikolić
Keyword(s):  
Case Report ◽  
Complete Remission ◽  
Direct Immunofluorescence ◽  
Cell Surfaces ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease ◽  
Iga Pemphigus ◽  
Subcorneal Pustular Dermatosis ◽  
Keratinocyte Cell ◽  
The Face

Abstract IgA pemphigus (IGAP) is a rare autoimmune bullous disease characterized by IgA deposits on keratinocyte cell surfaces. The IGAP is classified into: 1) subcorneal pustular dermatosis (SPD) type, and 2) intraepidermal neutrophilic (IEN) IgA dermatosis type. So far, only 9 children with IGAP have been described in the literature, of whom only 3 with SPD type. We report a 3-year-old boy with SPD type of IGAP. Clinically, he presented with pruritic vesicles, pustules and erosions on the face, trunk, groin area, and extremities. Histopathology showed subcorneal pustules containing a few acantholytic cells. Direct immunofluorescence (DIF) test of Tzanck smear showed intercellular IgA deposits on the surface of the groups of epidermal cells. Oral dapsone and prednisone induced remission after two weeks; the treatment was discontinued 11 months later, and complete remission was achieved during 19 months without any treatment. Direct immunofluorescence of Tzanck smear is a simple, sensitive, rapid and non-aggressive test, very suitable for the diagnosis of IGAP in children.

scholarly journals Severe Multi-Resistant Pemphigus vulgaris: prolonged remission with a single cycle of Rituximab

2013 ◽  
Vol 88 (4) ◽  
pp. 639-642 ◽  
Author(s):  
Isabela Soubhia Corral ◽  
Thais Helena Proença de Freitas ◽  
Renata Telles Rudge de Aquino ◽  
Daniella Abbruzzini S. Koller ◽  
Maria Elisa Ruffolo Magliari ◽  
...  
Keyword(s):  
Pemphigus Vulgaris ◽  
Immunosuppressive Drugs ◽  
Direct Immunofluorescence ◽  
Clinical Relapse ◽  
Single Cycle ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease ◽  
Systemic Corticosteroids ◽  
Daily Dose

Pemphigus vulgaris is an autoimmune bullous disease whose therapy is based on systemic corticosteroids, with or without immunosuppressants. Rituximab is a chimeric monoclonal antibody of the IgG class, directed at a specific CD20 B cell surface antigen, used in pemphigus vulgaris empirically since 2002, with success in 90% of the cases and long periods of remission. Male patient, 33 years old, diagnosed with pemphigus vulgaris, confirmed by histopathology and direct immunofluorescence. He was treated for seven months with numerous treatments, including immunosuppressive drugs, with an unsatisfactory response, until he had complete remission with the use of rituximab. During a 34-month follow-up period, the patient presented a slight clinical relapse, which was successfully controlled with prednisone in a daily dose of 120mg, soon reduced to 20mg.

scholarly journals An Atypical Presentation of Pemphigus Vegetans in the Umbilicus

2020 ◽  
Vol 4 (5) ◽  
pp. 452-455
Author(s):  
Antonio Jimenez ◽  
Paige Hoyer ◽  
Michael Wilkerson
Keyword(s):  
African American Woman ◽  
American Woman ◽  
Atypical Presentation ◽  
Treatment Resistant ◽  
Oral Ulcers ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease ◽  
Mucous Membranes ◽  
Pemphigus Vegetans ◽  
Desmoglein 3

Pemphigus is a chronic, autoimmune bullous disease that affects the skin and mucous membranes. Pemphigus vegetans is a rare variant of pemphigus and presents as oral ulcerations with associated verrucous lesions in intertriginous or flexural areas. A 38-year-old African American woman presented to the clinic with a chief complaint of oral ulcers. She carried a diagnosis of Behcet’s disease and was referred by rheumatology for evaluation of treatment-resistant mucosal ulcerations. At the time of her dermatology visit, she also reported an enlarging umbilical mass that had been present for several months.  Further examination of the umbilical lesion identified an exophytic, vegetative mass. Histologic assessment of the lesion identified acanthosis and acantholysis with dermal eosinophils consistent with pemphigus vegetans. A pemphigus antibody panel was done and resulted positive for IgG desmoglein-3 antibodies. The patient was treated with prednisone and rituximab with improvement of her lesions. We present an atypical presentation of pemphigus vegetans involving the umbilicus. This diagnosis should be considered in patients who present with oral erosions and concomitant vegetative lesions, regardless of location or prior diagnoses.

Atypical bullous pemphigoid after linagliptin intake (Preprint)

2020 ◽  
Author(s):  
Antoine Salloum ◽  
Nagham Bazzi ◽  
Maya Habre
Keyword(s):  
Skin Lesion ◽  
Basement Membrane ◽  
Upper Extremity ◽  
Bullous Pemphigoid ◽  
The Elderly ◽  
Direct Immunofluorescence ◽  
Erythematous Papule ◽  
Immunologic Reaction ◽  
Pruritic Skin

UNSTRUCTURED Bullous pemphigoid is among the commonest pruritic skin lesion and affecting mainly the elderly. It is caused by an immunologic reaction between auto-antibodies and hemidesmosome proteins. Several forms of typical bullous pemphigoid post linaglipltin have been reported. However, this is the first reported case of atypical non-bullous pemphigoid after linagliptin intake. The patient presented with multiple erythematous papule and nodules on the upper extremity and on trunk. Diagnosis was made with biopsy followed by direct immunofluorescence. Direct immunofluorescence showed linear IgG and C3 antibodies to hemidesmosomes at lamina Lucida of the basement membrane.

Regulatory T-cell deficiency leads to pathogenic bullous pemphigoid antigen 230 autoantibody and autoimmune bullous disease

2018 ◽  
Vol 142 (6) ◽  
pp. 1831-1842.e7 ◽  
Author(s):  
Stefanie Haeberle ◽  
Xiaoying Wei ◽  
Katja Bieber ◽  
Stephanie Goletz ◽  
Ralf J. Ludwig ◽  
...  
Keyword(s):  
T Cell ◽  
Bullous Pemphigoid ◽  
Regulatory T Cell ◽  
Bullous Pemphigoid Antigen ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease

scholarly journals Anti-P 200 pemphigoid – The most common floor binding subepidermal autoimmune bullous disease in a tertiary care center in south India

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Reena Rai ◽  
J. Bede Anand ◽  
C. Shanmugasekar ◽  
P. Arunprasath ◽  
V. Chaitra ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Immunofluorescence Microscopy ◽  
Care Center ◽  
Tertiary Care ◽  
Target Antigen ◽  
Direct Immunofluorescence ◽  
Bullous Disease ◽  
Bullous Diseases ◽  
Split Skin ◽  
Laminin 332

Background: The pemphigoid group of diseases may present clinically and immunologically in a very similar fashion. Indirect immunofluorescence microscopy with readily available salt-split human skin in a BIOCHIP™ helps to classify these conditions as those with either with roof binding or floor binding of immunoreactants. Epidermolysis bullosa acquisita, anti-laminin 332 pemphigoid and anti-p200 pemphigoid show floor binding, while in the most frequent type of pemphigoid disease, bullous pemphigoid, epidermal side staining pattern is seen on salt-split skin Aims: The aim of the study was to detect the target antigens in sub-epidermal bullous diseases. Methods: Forty patients with bullous pemphigoid diagnosed by lesional histopathology and direct immunofluorescence microscopy were re-evaluated by a BIOCHIP™ mosaic containing both tissue substrates and recombinant target antigens. Sera with floor pattern staining on salt-split skin were further evaluated by immunoblotting with dermal extract. Results: Five patients with floor staining had anti-p200 pemphigoid. Limitations: We could not perform serration pattern analysis of direct immunofluorescence in our patients. Conclusion: Histopathology and direct immunofluorescence microscopy cannot differentiate between various entities of pemphigoid diseases. A multivariant approach using a BIOCHIP™ mosaic including salt-split skin followed by immunoblotting with dermal extract helps to identify the target antigen.

scholarly journals Bullous pemphigoid: Case report and review of literature​

2021 ◽  
pp. 125-128
Author(s):  
Shunmugavelu KARTHIK ◽  
Shanmugam ARASU ◽  
Srikanthan SRIRAM ◽  
Evangeline Cynthia DHINAKARAN ◽  
Yalamanchi ANUSHA ◽  
...  
Keyword(s):  
Case Report ◽  
Bullous Pemphigoid ◽  
Chief Complaint ◽  
Topical Steroids ◽  
Oral Lesions ◽  
Incisional Biopsy ◽  
Review Of Literature ◽  
The Past ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease

Bullous pemphigoid (BP) is an autoimmune bullous disease characterized by subepithelial blistering mostly affecting elderly but may be seen in all ages. A 52-year-old female patient came with a chief complaint of itching, redness and ulcer in the hands and oral cavity for the past 2 weeks. The examination revealed ulcer- ated lesions in palate and buccal mucosa. Erythematous lesions were also seen in upper limb. Incisional biopsy was done and histological examination revealed bullous pemphigoid. The patient was immediately started with systemic and topical steroids and was continued for 3 weeks. The extra-oral lesions were healed and intraoral ulcerations subsided after 3 weeks.

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