Dyshidrosiform Bullous Pemphigoid: A Palmar Variant of a Common Disease

Dyshidrosiform bullous pemphigoid (DBP) is a rare variant of bullous pemphigoid (BP) that mainly affects elderly patients and presents with tense bullae formation on the palms, soles, or both palms and soles. This case report describes an 87-year-old woman who was evaluated in the hospital for a month-long erythematous and pruritic rash on most of her body that eventually manifested into tense blisters on the palms. DBP can pose a challenge to clinicians as it can resemble a variety of different vesicular diseases. Therefore, clinical suspicion, as well as confirmatory testing with direct immunofluorescence (DIF), can aid clinicians in making a diagnosis of DBP. The mainstay of treatment is oral corticosteroids plus an immunosuppressant, but some monoclonal antibodies have shown promising efficacy in the treatment of more refractory cases of DBP. Additional research that focuses on the role of these monoclonal antibodies in the treatment of DBP is needed to determine their therapeutic benefit.