Abstract

Bullous pemphigoid is an acquired autoimmune blistering disorder, typically affects 70 years and older. It is characterized by “subepidermal bullae and deposition of complement and antibodies along the basement membrane zone”. The classical presentation includes prodromal stage ,non bullous stage and bullous stage. But bullous pemphigoid is a “great mimicker”, it shows polymorphic . The presence of bullae is probably not always necessary in defining BP because it is a polymorphic disease. Urticarial, erythematous, and eczematous patches, plaques that are targetoid, nodular, lichenoid, vesicular, or polycyclic lesions are further potential lesions. Unlike classical BP , in childhood and adolescent ,incidence rate is low, palmoplantar involvement is common, has good prognosis. Localized BP occurs 16% to 29% of all cases of bullous pemphigoid. Furthermore, it is becoming more and more clear that bullous pemphigoid diagnosis criteria should be developed globally, to enable diagnosis even when the clinical presentation of the patient is unusual. It is also essential to recognise atypical clinical signs and symptoms of bullous pemphigoid in order to start the right treatment as soon as feasible. Particularly because such kinds of BP have a lower response to medication and novel therapeutic approaches need to be used
. DIF of perilesional skin showing IgG or C3 deposits or both, and the detection of circulating antibodies against the two main antigens of BP, are the two cornerstones in the diagnosis, particularly when the clinical presentation is doubtful.