Recalcitrant bullous pemphigoid induced by rabies vaccine − report of a rare causal association

Bullous pemphigoid (BP) is an autoimmune blistering disease characterized by autoantibodies towards basement membrane zone antigens BP180 and BP230. There are many known trigger factors for this immunobullous disorder such as ultraviolet (UV) radiation, drugs, trauma, and burns. Various vaccines have also been known to trigger the onset of bullous pemphigoid such as diphtheria, pertussis, polio, and coronavirus disease 2019 (COVID-19) vaccines. Here we report a 47-year-old Indian female who developed BP after 7 days of completion of the inactivated rabies vaccine (Essen regimen) schedule.