BULLOUS PEMPHIGOID: A CLASSICAL CASE REPORT MANAGED WITH PULSE THERAPY

Dr. M. A. Lavanya*, Dr. Nirumal Rakkesh M. and Dr. Naveen K. Erusappan

ABSTRACT

Bullous pemphigoid is an autoimmune blistering disorder that typically presents in elderly patients as pruritic tense subepidermal blisters. It presents clinically with diffuse eczematous, pruritic, urticaria-like lesions, with the later appearance of tense bullae or blistering lesions typically filled with clear fluid. It primarily affects elderly individuals with an average age of onset being 65 years.Bullous Pemphigoid (BP) can be diagnosed clinically with a high index of suspicion with the aid of skin biopsy and histology.[1] A 64 year old female patient with known comorbidities of Systemic hypertension and type2 diabetes mellitus, presented with complaints of multiple vesicles all over the body, pain and burning sensation all over the body since 20days. She was initially treated in nearby clinic for the same. She had past surgical history of lump excision on scalp few years back. On physical examination, some of the lesions had ruptured and were both pruritic and painful. Baseline blood investigations done. Skin biopsy was done revealed Bullous Pemphigoid. Dermatologist opinion was sought in view of painful blisters on she advised for 3 days cycle Pulse therapy. The pathogenesis of BP is complex and its treatment and management still represents a challenge due to higher frequency of several comorbidities in this group of patients which may leads to tolerance to Bullous Pemphigoid treatments. Hence an early diagnosis and a prompt treatment are mandatory to reach better clinical outcome.The aim of this case report is to present a classic case of this condition, to highlight an awareness of differing treatment options, and to advocate referral to a dermatologist given its potential severity.

Keywords: Bullous Pemphigoid, Pulse therapy, Autoimmune-disease.