case_images: PMC11787808_01
case_images: Initial presentation of bullous pemphigoid. Erythematous papules are shown on the back, accompanied by the onset of pruritus.
case_images: cureus-0017-00000076856-i01.jpg
case_images: PMC11787808_01_cureus-0017-00000076856-i01.jpg
case_images: FIG1
case_images: As the pruritus intensified, erythematous papules developed on his bilateral arms and back, as shown in Figure 1, highlighting the lesions on his back.
case_images: Histopathologic features of bullous pemphigoid on hematoxylin and eosin stain. (A) Low-power view (40x magnification) of a hematoxylin and eosin-stained section from a shave biopsy of an erythematous papule on the back. A subepidermal blister is evident, defined by separation at the dermoepidermal junction, with a cavity containing a mixed inflammatory infiltrate. The black arrows indicate the borders of the epidermis and dermis, highlighting the large cavity between them. (B) High-power view (100x magnification) provides greater detail of the subepidermal blister, revealing inflammatory infiltrates composed predominantly of eosinophils and lymphocytes within the blister cavity and upper dermis. The surrounding dermis exhibits edema and prominent eosinophilic infiltration (indicated by black arrows), findings characteristic of bullous pemphigoid.
case_images: cureus-0017-00000076856-i02.jpg
case_images: PMC11787808_01_cureus-0017-00000076856-i02.jpg
case_images: FIG2
case_images: At the dermatology clinic, a shave biopsy of an erythematous papule on the back was performed, revealing histopathological findings characterized by a significant eosinophilic infiltrate consistent with subepidermal bullous disease (Figure 2).
case_images: Clinical progression of bullous pemphigoid. (A) Healing erythematous erosions on the chest, (B) axilla, and (C) knee, demonstrating areas of post-inflammatory hyperpigmentation following the resolution of tense bullae.
case_images: cureus-0017-00000076856-i03.jpg
case_images: PMC11787808_01_cureus-0017-00000076856-i03.jpg
case_images: FIG3
case_images: Healing erosions on the patient's chest, axilla, and knee are depicted in Figure 3.