Ijaz Hussain, Zahida Rani, Tariq Rashid.
Dyshydrosiform Bullous Pemphigoid A case report with review of literature.
J Pak Assoc Derma Jan ;11(1):69-71.

We report a case of bullous pemphigoid who presented with dyshidrosiform eruption on her palms. The eruption showed typical histopathological and immunofluorescence changes of bullous pemphigoid. Clinicians should be vigilant about this uncommon presentation of disease.

CASE REPORT: A 65-year old female, a known case of bullous pemphigoid for the last 5 years, presented to the Department of Dermatology, Mayo Hospital, Lahore with generalized vesiculobullous eruption for the last 3 weeks. The disease recurred every summer starting with generalized pruritus followed by generalised vesiculobullous eruption within 23 weeks. Every time she was hospitalized and treated with dapsone, minocycline or prednisolone. All the attacks settled within 3-4 weeks. In July, 1999, she presented to the department after about one year of remission. This time the disease relapsed with appearance of vesicles and bullae on the palms bilaterally and then extending to the rest of the body within a week. On examination, she was found to have erosions and hemorrhagic crusting on both palms. There were multiple, discrete and grouped, tense vesicles and bullae on erythematous and non-erythematous base on various parts of limbs and trunk. There were minimal erosions along with crusted lesions. Paronychia of middle, index and ring fingers of left hand was present along with erosions and crusting on the lower lip.

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