Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter To Editor
2006:72:2;158-159
doi: 10.4103/0378-6323.25651
PMID: 16707831

Localised bullous pemphigoid in the breast

C Balachandran, Vandana Mehta Rai
 Department of Skin and STD, Kasturba Medical College and Hospital, Manipal, Karnataka, India

Correspondence Address:
C Balachandran
Department of Skin and STD, Kasturba Medical College and Hospital, Manipal 576 104, Karnataka
India
How to cite this article:
Balachandran C, Rai VM. Localised bullous pemphigoid in the breast. Indian J Dermatol Venereol Leprol 2006;72:158-159
Copyright: (C)2006 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

A 20-year-old woman presented with recurrent vesiculobullous lesions associated with itching, oozing and crusting around the right areola of 1 year′s duration. The lesions used to subside temporarily with topical steroids and oral antibiotics. On examination, there were vesicles and bullae with crusting and erosions around the right areola. No other areas were involved. There were no oral or genital lesions. Systemic examination was normal.

The clinical diagnosis of localized bullous pemphigoid (BP) was confirmed by direct immunofluorescence study of perilesional skin, which showed linear IgG and C3 deposits at the basal membrane level [Figure - 1]. Histopathological examination of a biopsy revealed a subepidermal blister. Indirect immunofluorescence with salt split skin examination and immunomapping is required to confirm the diagnosis and exclude the possibility of localized trauma-induced epidermolysis bullosa acquisita.[1] This was not performed in our patient as she improved dramatically with dapsone 100 mg orally daily and a topical clobetasol propionate-gentamicin combination; the rapid response to treatment makes the diagnosis of epidermolysis bullosa acquisita in our patient unlikely, as this disease does not usually respond well to treatment. Dapsone 100 mg daily was continued for 6 months. There was no relapse on follow-up after another six months.

Localized BP is infrequent, but has been documented following radiotherapy, in surgical wounds, secondary to trauma or burns and peristomal lesions.[2],[3],[4] Localized BP affecting the pretibial, oral or vulvar region has also been described,[5] but its pathogenesis is not clear. Some authors consider it the result of different forms of epidermal damage (Koebners phenomenon) in predisposed patients, with the induction of antigen exposure in the context of subclinical pemphigoid followed by activation of the corresponding autoimmune process.[6] While localized BP of the breast after, for example, radiotherapy has frequently been described,[7] we could not find any trigger in our patient. Potent topical corticosteroids are very useful in the treatment of localized BP. The addition of dapsone along with a small dose of oral steroids may be also helpful in patients with recalcitrant disease. Our patient responded well to treatment with oral dapsone and a topical steroid-antibiotic combination.

References
1.
Dejong MC, Kardaun SH, Tupker RA, Seijen WG. Immunomapping in localized bullous pemphigoid. der Hautarzt 1989;40:226-30.[Quoted from: Dejong MC, Bruins S. Bullous pemphigoid and epidermolysis bullosa acquisita. Differentiation by fluorescence overlay antigen mapping. Arch Dermatol 1996;132:151-7.]
[Google Scholar]
2.
Macfarlane AW, Verbod JL. Trauma induced bullous pemphigoid. Clin Exp Dermatol 1989;14:245-9.
[Google Scholar]
3.
Vermeulen C, Janier M, Pansei, Daniel F. Localized bullous pemphigoid induced by thermal burn. Ann Dermatol Venereol 2000;127:720-2.
[Google Scholar]
4.
Salomon RJ, Briggaman RA, Wernikoff SY, Kayne AL. Localized bullous pemphigoid: A mimic of acute contact dermatitis. Arch Dermatol 1987;123:389-92.
[Google Scholar]
5.
De Castro P, Jorizzo JL, Rajaraman S, Solomon AR, Briggaman RA, Raimer SS. Localized vulvar pemphigoid in a child. Pediatric Dermatol 1985;2:302-7.
[Google Scholar]
6.
Pardo J, Serna MR, Mercader P, Fortea JM. Localized bullous pemphigoid overlying a fistula for hemodialysis. J Am Acad Dermatol 2004;51:131-2.
[Google Scholar]
7.
Calikoglu E, Anadolu R, Erdem C, Calikoglu T. Localized bullous pemphigoid as an unusual complication of radiation therapy. J Eur Acad Dermatol Venereol 2002;16:646-7.
[Google Scholar]

Fulltext Views
1,661

PDF downloads
621
Show Sections