Jornal de Pesquisa em Dermatologia Clínica e Experimental
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Erythema Multiforme-Like Bullous Pemphigoid Associated with Furosemide

Stefanie A. Hirano, Ashley R. Mason, Valerie M. Harvey and Antoinette F. Hood

The clinical diagnosis of bullous pemphigoid (BP) can be challenging given the polymorphic nature of the disease. We present a case of erythema multiforme (EM)-like BP in an 80-year-old woman with celiac disease. Skin biopsies showed intraepidermal and subepidermal bullae with direct immunofluorescence (DIF) demonstrating IgG and C3 linear deposition at the basement membrane. The etiology of our patient's BP is unclear but may be associated with furosemide usage and is temporally associated with a flare of celiac sprue. To our knowledge, only four other published cases document EM-like lesions in BP. Atypical presentations of BP should be confirmed with histology and direct immunofluorescence.