- Email: [email protected]
Bullous pemphigoid on surgical scar
Med Clin (Barc). 2015;144(1):e1
www.elsevier.es/medicinaclinica
Image of the week
Bullous pemphigoid on surgical scar夽 Penfigoide ampolloso sobre cicatriz quirúrgica Cristina Garrido Colmenero a,∗ , Elia García Durá a , José Aneiros Fernández b , Salvador Arias Santiago a a b
Unidad de Gestión Clínica de Dermatología Médico Quirúrgica y Venereología, Hospital Universitario Virgen de las Nieves, Granada, Spain Unidad de Gestión Clínica de Anatomía Patológica, Hospital Universitario Virgen de las Nieves, Granada, Spain
Fig. 1.
Fig. 2.
Fig. 3.
The first patient, a woman of 73 years, presented a pruritic cutaneous rash seven days after laparoscopic cholecystectomy was performed. She also presented serohemorrhagic bullous located in the periumbilical area, surrounding the scar (Fig. 1). The second patient, a woman of 78 years, who, five days after pacemaker insertion, due to a third degree atrioventricular block, reported erythematous and bullous rash in the region of the scar. This rash spread to the rest of the cleavage showing extensive erosion lesions (Fig. 2). Among differential diagnosis we assessed: bullous impetigo; contact dermatitis; bullous lichen planus; pemphigus vulgaris; erythema multiforme; fixed drug eruption, bullous; and viral causes like herpes or varicella zoster virus. In both cases cutaneous biopsies were performed. The histological findings were compatible with bullous pemphigoid (BP), and the direct immunofluorescence test showed linear deposits of IgG and C3 (Fig. 3). Treatment chosen was clobetasol cream twice a day. Patients achieved remission of injuries in less than two months. There was no relapse after six months of follow-up. The presence of blisters on recent surgical scar wounds requires discarding BP.
夽 Please cite this article as: Garrido Colmenero C, García Durá E, Aneiros Fernández J, Arias Santiago S. Penfigoide ampolloso sobre cicatriz quirúrgica. Med Clin (Barc). 2015;144:e1. ∗ Corresponding author. E-mail address: [email protected] (C. Garrido Colmenero). ˜ S.L.U. All rights reserved. 2387-0206/© 2014 Elsevier Espana,
www.elsevier.es/medicinaclinica
Image of the week
Bullous pemphigoid on surgical scar夽 Penfigoide ampolloso sobre cicatriz quirúrgica Cristina Garrido Colmenero a,∗ , Elia García Durá a , José Aneiros Fernández b , Salvador Arias Santiago a a b
Unidad de Gestión Clínica de Dermatología Médico Quirúrgica y Venereología, Hospital Universitario Virgen de las Nieves, Granada, Spain Unidad de Gestión Clínica de Anatomía Patológica, Hospital Universitario Virgen de las Nieves, Granada, Spain
Fig. 1.
Fig. 2.
Fig. 3.
The first patient, a woman of 73 years, presented a pruritic cutaneous rash seven days after laparoscopic cholecystectomy was performed. She also presented serohemorrhagic bullous located in the periumbilical area, surrounding the scar (Fig. 1). The second patient, a woman of 78 years, who, five days after pacemaker insertion, due to a third degree atrioventricular block, reported erythematous and bullous rash in the region of the scar. This rash spread to the rest of the cleavage showing extensive erosion lesions (Fig. 2). Among differential diagnosis we assessed: bullous impetigo; contact dermatitis; bullous lichen planus; pemphigus vulgaris; erythema multiforme; fixed drug eruption, bullous; and viral causes like herpes or varicella zoster virus. In both cases cutaneous biopsies were performed. The histological findings were compatible with bullous pemphigoid (BP), and the direct immunofluorescence test showed linear deposits of IgG and C3 (Fig. 3). Treatment chosen was clobetasol cream twice a day. Patients achieved remission of injuries in less than two months. There was no relapse after six months of follow-up. The presence of blisters on recent surgical scar wounds requires discarding BP.
夽 Please cite this article as: Garrido Colmenero C, García Durá E, Aneiros Fernández J, Arias Santiago S. Penfigoide ampolloso sobre cicatriz quirúrgica. Med Clin (Barc). 2015;144:e1. ∗ Corresponding author. E-mail address: [email protected] (C. Garrido Colmenero). ˜ S.L.U. All rights reserved. 2387-0206/© 2014 Elsevier Espana,