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F. Huet, A. Karam, G. Lemasson, F. Jouen, H. Sonbol, L. Misery, C. Abasq‐Thomas, Image Gallery: Erythroderma revealing a nonbullous bullous pemphigoid, British Journal of Dermatology, Volume 175, Issue 5, 1 November 2016, Pages e136–e137, https://doi.org/10.1111/bjd.14982
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Funding sources: none.
Conflicts of interest: none declared.
Dear Editor, A 91‐year‐old man presented with an exfoliative erythroderma with ectropion (a). Palmoplantar hyperkeratosis (b) and intense pruritus without any blisters were found. Bullous pemphigoid (BP) was confirmed by direct immunofluorescence (DIF), indirect immunofluorescence (circulating IgG autoantibodies that bind to the epidermal side of salt‐split normal human skin; c) and enzyme‐linked immunosorbent assay. The absence of blisters during 2 years of follow‐up suggested that our patient had a distinct nonbullous variant of BP. BP is the most frequent autoimmune bullous dermatosis.1 Several atypical variants are known,2 including erythrodermic BP. DIF is the most specific diagnostic method for BP and might be performed after the elimination of the principal aetiologies of erythroderma.