Abstract

Background: Bullous pemphigoid belongs to the group of subepidermal autoimmune blistering diseases characterized by the production of autoantibodies against various components of the basement membrane. These antibodies are of the IgG class and bind primarily to two hemidesmosomal proteins, BP180 and BP230 antigens. In Mexico, there are no epidemiological reports; however, isolated case reports have been described. Clinical case: An 80-year-old male with a history of poliomyelitis presented with disseminated dermatosis involving the anterior thorax, posterior thorax, and both extremities. The condition was characterized by polymorphic vesiculobullous lesions, multiple in number, ranging from 0.3 to 3.7 cm, with an erythematous base, intensely pruritic, and associated with hemorrhagic crusts and excoriations. Histopathological examination revealed multiple subepidermal blisters with a predominance of eosinophils, hyperkeratosis with a “basket-weave” pattern, and eosinophilic spongiosis, findings consistent with bullous pemphigoid. Blood tests showed prostate-specific antigen levels above normal limits, suggestive of malignancy. A PET scan demonstrated overexpression of type 2 carboxypeptidase receptors of neoplastic origin in the prostate, with infiltration into the right seminal vesicle and probable rectal involvement. Conclusions: Bullous pemphigoid and its association with prostate cancer is an uncommon clinical occurrence. It is recommended that both conditions be addressed with equal clinical priority and that treatment be initiated promptly to halt the progression of dermatologic lesions, reduce the risk of metastatic dissemination associated with prostate cancer, and prevent long-term functional sequelae.

Keywords

bullous pemphigoid, prostate cancer, skin