Pigmented bullous pemphigoid

Background. Pigmented bullous pemphigoid has many clinical manifestations. We report a pigmented erythematous form with disseminated bullae. Case report. A 70-year-old woman with a history of breast adenocarcinoma de veloped an eruption of pigmented macules on the trunk and members of 72 hou r duration. At five days, there was an eruption of tight bullae. The diagno sis of bullous pemphigoid was retained because of the association of infrae pidermic bullae, linear deposits of C-3 along the basal membrane and the pr esence of the 180 kDa minor bullous pemphigoid antigen on immunoblotting. Discussion. The initial pigmented aspect of this bullous pemphigoid suggest ed disseminated pigmented bullous erythema, but histology data with immunot ransfer corrected the diagnosis. This very atypical presentation led us to look for a particular etiology. There was no argument in favor of a maligna ncy in this patient in complete remission after treatment of her breast ade nocarcinoma. The fact that the patient was phototype IV would probably expl ain the pigmented nature of the initial lesions.