PEMPHIGOID STIMULATING ACQUIRED BULLOUS E PIDERMOLYSIS

Introduction. Subepidermal autoimmune bullous dermatoses form a clinic al entity for which there is not always an individualized clinical and pathological description. Case report. A patient presented with bullo us skin disease of atypical nature. There was an almost total desepide rmization of the legs, vast areas of erosion on the trunk and arms wit h a Nikolski sign in an area of healthy skin, buccal involvement, mult iple milium cysts and ungueal dystrophies with nail loss.Discussion. T his clinical presentation in this patient suggested acquired bullous e pidermolysis. However, according to the recently defined clinical crit eria for pemphigoid, the probability of correct diagnosis of pemphigoi d was greater than 95 p. 100 since nearly three fourths of the major c riteria were present. This diagnosis was confirmed by reference techni ques (electron microscopy, indirect electron immunomicroscopy and immu noblotting). Thus, bullous autoimmune diseases of the dermoepidermal j unction can be reliably differentiated on the bases of the clinical fe atures, together with direct and indirect immunofluorescence on salt-s plit skin.