title: Localized bullous pemphigoid in a patient with primary lymphoedema tarda.
abstract: We report a case of localized bullous pemphigoid (BP) in a woman patient with primary lymphoedema tarda. There is only one previous case reported of localized pemphigoid in an area of lymphoedema, this being of the cicatricial variant. Slow circulation in the lymphatic vessels, increased capillary permeability with preferential localization of antibodies in the area, and potential cleavage of the epidermal junction due to increased hydrostatic pressure leading to autoimmunity, have all been advocated as possible pathogenic mechanisms. Nevertheless, we consider that the mechanism by which localized pemphigoid arises on lymphoedema remains elusive, based on a previous case of generalized BP sparing an area of postsurgical lymphoedema.
authors.affiliation: St John's Institute of Dermatology, St Thomas' Hospital, London, UK. alfonso.perez@gstt.nhs.uk
authors.forename: A
authors.initials: A
authors.lastname: Perez
authors.forename: S E
authors.initials: SE
authors.lastname: Clements
authors.forename: E
authors.initials: E
authors.lastname: Benton
authors.forename: A
authors.initials: A
authors.lastname: Robson
authors.forename: B
authors.initials: B
authors.lastname: Bhogal
authors.forename: C M
authors.initials: CM
authors.lastname: Stefanato
authors.forename: D
authors.initials: D
authors.lastname: McGibbon
mesh_terms: D000368:Aged; D002481:Cellulitis / Q000150:complications*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000188:drug therapy / Q000473:pathology*; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010391:Pemphigoid, Bullous / Q000188:drug therapy / Q000473:pathology*
chemical_list: D003879:Dermatologic Agents; D009173:Mycophenolic Acid