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What is causing these lesions?

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A 60 year-old female presented with a history of intermittent episodes of tense, fluid-filled blisters covering her abdomen, back, and arms.

Upon rupturing, moist erosions developed resulting in postinflammatory hyperpigmentation, as shown in the image above. What condition is the description of these lesions consistent with?

Answer: This patient is suspected to have bullous pemphigoid, a relapsing and remitting autoimmune disease in which widespread, tense, fluid-filled cutaneous bullae develop.

These may be preceded by a prodromal phase of pruritic skin lesions.

Severe pruritus may be the only manifestation in some patients.

It is commonly treated with corticosteroids and immunosuppressants.

View this and similar cases on Figure 1.

 

 

 

 

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