Drug-Induced Bullous Pemphigoid: Rapid Resolution with Corticosteroid Therapy

Introduction: Bullous pemphigoid (BP), an autoimmune condition that mostly affects the elderly and is marked by subepidermal blisters. Although the pathophysiology of this condition is still not entirely known, it is thought to have a close relationship with a number of medications. The treatment effectiveness is dependent on the severity of the patient's ailment and comorbidities. Case: A 76-year-old man with many blisters and bodily erosions. The patient expresses discomfort and itching. Upon physical examination, it is seen that the upper and lower extremities have a large number of tense-walled bullae with numerous erosions and crusts. Subepidermal blistering with eosinophilic and lymphocytic infiltrate is visible on skin biopsy. Desoximetasone was applied topically to him, and oral methylprednisolone (MP) was administered. MP is gradually reduced in accordance with the patient's development. Treatment for hypertension was also suspended till the condition became better. The patient's condition improved as a result, and no new blisters appeared. Discussion: The best methods for ruling out other blistering diseases when diagnosing bullous pemphigoid, besides clinical symptoms, continue to be direct immunofluorescence and skin biopsy. Other than a mix of oral and topical glucocorticoids for the treatment of drug-induced BP, stopping some medications will have an immediate effect and is typically more responsive. Reducing the dosage and overall duration of oral glucocorticoids is crucial since systemic glucocorticoids can have some negative effects, particularly in the elderly. Conclusion: Bullous pemphigoid patients should constantly be wary of drug-induced bullous pemphigoid when receiving several therapies. Because most patients respond quickly to treatment after the suspected substance is stopped, this possibility should be taken into account.