PMC5906537_01
(A) Tense blisters and erosions of less than 2 cm in diameter developed over the thermal burn scar on the right forearm. Circumscribed erythematous lesions were also found. (B) Small erosions of less than 5 mm in diameter were found on the trunk without erythema. (C) Histopathological examination of the blister shows sub-epidermal blistering with some eosinophilic infiltration in the dermis. Scale bar: 100 microm. (D) Direct immunofluorescence shows linear IgG autoantibody deposits at the basement membrane zone (arrowheads).
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F1
Physical examination revealed tense blisters and erosions of 5 mm to 2 cm in diameter with circumscribed erythematous lesions predominantly on the right forearm (Figure 1A). Blisters and erosions less than 5 mm in diameter without erythema were found on the face, the trunk, and the left leg (Figure 1B). Although BP180 NC16A chemiluminescent enzyme immunoassay (CLEIA) was negative (5.9 U/mL; normal, <9.0 U/mL), histopathological examination of the blister showed sub-epidermal blister formation with some eosinophilic infiltration in the dermis (Figure 1C).
Indices of the bullous pemphigoid (BP) disease area index scores and enzyme-linked immunosorbent assay (ELISA) using full-length recombinant BP180 during the clinical course.
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F2
Complete remission off therapy was achieved 4 months later (Figure 2). At 2 months after the cessation of treatment, no recurrence was observed (Figure 2).