Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
Kasahara Clinic, Niigata, Japan
Ito Dermatology Clinic, Nagaoka, Japan
Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
Background: Localized bullous pemphigoid is a relatively rare variant of bullous pemphigoid. Lesions develop only in localized sites including the legs or palms and soles and occasionally appear in trauma-affected body parts. In some cases, the skin lesions spread to the entire body, while in others, they remain localized and improve spontaneously or with treatment using topical corticosteroids. Rarely, the lesions recur at sites different from those of the original lesions, after the initial lesions have completely healed. Objectives: To investigate the clinical course of patients with localized bullous pemphigoid. Materials and Methods: Two cases of localized bullous pemphigoid that recurred at sites distant from those of the initial lesions were reported. Results: Case 1 involved a 62-year-old woman with mucous membrane pemphigoid. One year after the improvement of mucosal symptoms, new lesions appeared in the periumbilical area. The lesions resolved after topical corticosteroid treatment. This case is the first report of localized bullous pemphigoid occurring after an improvement of mucous membrane pemphigoid. Case 2 involved an 81-year-old man who bruised his right lower leg and developed erythematous plaques and tense bullae. The patient was diagnosed with localized bullous pemphigoid and was treated with topical corticosteroid. However, six months later, new lesions appeared on the palms and soles. The patient responded well to oral prednisolone. Conclusions: Since localized bullous pemphigoid may have a variable clinical course, clinicians should observe affected patients carefully over a long period of time.