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Pemphigoid nodularis - rare presentation of bullous pemphigoid: A case report and literature review

  • Authors:
    • Corina Vornicescu
    • Simona Corina Șenilă
    • Rodica Cosgarea
    • Elisabeta Candrea
    • Alexandra Dana Pop
    • Loredana Ungureanu
  • View Affiliations / Copyright

    Affiliations: Department of Dermatology, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania, Department of Physiology, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
    Copyright: © Vornicescu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 1132-1138
    |
    Published online on: December 5, 2018
       https://doi.org/10.3892/etm.2018.7057
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Abstract

Pemphigoid nodularis (PN) is a rare clinical variant of bullous pemphigoid characterized by the presence of nodular prurigo-like lesions and pemphigoid blisters. The diagnosis is confirmed by direct immunofluorescence (DIF)/ indirect immunofluorescence (IIF) and immunoserology tests. For some patients, with long mean duration of symptoms, the correct diagnosis of PN is delayed because the disease is not recognized. We present a case and summarize the reported characteristics of PN. The search in MEDLINE database, after selection, resulted in 36 articles presenting 47 cases of PN. Between published cases a female predominance was noted (female to male ratio of 1.8:1), almost half of the reported patients were non-Caucasian, and the mean age at presentation was 66.2 years. The mean duration until the diagnosis was almost 2 years. Sixteen patients also had other autoimmune diseases. Twenty-two patients developed vesicles/bullae/urticarial plaques before or after the diagnosis. Peripheral eosinophilia and high levels of serum total IgE were reported in 10.6 and 27.2% of patients, respectively. ELISA for either BP180, BP230 or both were positive in all tested cases. DIF and IIF microscopy were positive overall in 100 and 92.3% of cases, respectively. Corticosteroids, either topical or systemic, were the most efficient therapeutic option, although many others were used. PN remains a diagnostic and therapeutic challenge in elderly patients with unexplained refractory chronic pruritus associated with papulo-nodular lesions.
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Copy and paste a formatted citation
Spandidos Publications style
Vornicescu C, Șenilă SC, Cosgarea R, Candrea E, Pop AD and Ungureanu L: Pemphigoid nodularis - rare presentation of bullous pemphigoid: A case report and literature review. Exp Ther Med 17: 1132-1138, 2019.
APA
Vornicescu, C., Șenilă, S.C., Cosgarea, R., Candrea, E., Pop, A.D., & Ungureanu, L. (2019). Pemphigoid nodularis - rare presentation of bullous pemphigoid: A case report and literature review. Experimental and Therapeutic Medicine, 17, 1132-1138. https://doi.org/10.3892/etm.2018.7057
MLA
Vornicescu, C., Șenilă, S. C., Cosgarea, R., Candrea, E., Pop, A. D., Ungureanu, L."Pemphigoid nodularis - rare presentation of bullous pemphigoid: A case report and literature review". Experimental and Therapeutic Medicine 17.2 (2019): 1132-1138.
Chicago
Vornicescu, C., Șenilă, S. C., Cosgarea, R., Candrea, E., Pop, A. D., Ungureanu, L."Pemphigoid nodularis - rare presentation of bullous pemphigoid: A case report and literature review". Experimental and Therapeutic Medicine 17, no. 2 (2019): 1132-1138. https://doi.org/10.3892/etm.2018.7057
Copy and paste a formatted citation
x
Spandidos Publications style
Vornicescu C, Șenilă SC, Cosgarea R, Candrea E, Pop AD and Ungureanu L: Pemphigoid nodularis - rare presentation of bullous pemphigoid: A case report and literature review. Exp Ther Med 17: 1132-1138, 2019.
APA
Vornicescu, C., Șenilă, S.C., Cosgarea, R., Candrea, E., Pop, A.D., & Ungureanu, L. (2019). Pemphigoid nodularis - rare presentation of bullous pemphigoid: A case report and literature review. Experimental and Therapeutic Medicine, 17, 1132-1138. https://doi.org/10.3892/etm.2018.7057
MLA
Vornicescu, C., Șenilă, S. C., Cosgarea, R., Candrea, E., Pop, A. D., Ungureanu, L."Pemphigoid nodularis - rare presentation of bullous pemphigoid: A case report and literature review". Experimental and Therapeutic Medicine 17.2 (2019): 1132-1138.
Chicago
Vornicescu, C., Șenilă, S. C., Cosgarea, R., Candrea, E., Pop, A. D., Ungureanu, L."Pemphigoid nodularis - rare presentation of bullous pemphigoid: A case report and literature review". Experimental and Therapeutic Medicine 17, no. 2 (2019): 1132-1138. https://doi.org/10.3892/etm.2018.7057
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