(1)
Misdiagnosis Association & Society, Seattle, WA, USA
Keywords
Differential diagnosisImmunoglobulin A (IgA)Cutaneous lesionsBullous pemphigoidErythema multiformeHailey-Hailey diseaseLinear IgA bullous dermatosisTransient acantholytic dermatosis (Grover’s disease)Pemphigus vegetansPemphigus foliaceusPemphigus erythematosusParaneoplastic pemphigusHerpetiform pemphigusDrug-induced pemphigusIgA pemphigusBullous Pemphigoid
Bullous pemphigoid is also a chronic blistering disease like pemphigus vulgaris; however, it mainly affects people over the age of 60 and the blisters mainly cover the arms and legs, as well as the trunk area of the patients [1, 2]. In this condition, the blisters are itchy, unlike those seen in pemphigus foliaceus, and they are rarely found in the mouth area [2]. This disease is subepidermal in nature, whereas pemphigus vulgaris is epidermal [2].
Erythema Multiforme
Usually patients with erythema multiforme have a previous herpes simplex virus (HSV) infection history [3]. This is a self-limited skin disease in which there are characteristic skin lesions that are target shaped; there is an outer circle of redness surrounding blisters and lesions centrally. These target-shaped lesions have fast onset and appear within a period of 24 h.
Hailey-Hailey Disease
Hailey-Hailey is a rare autosomal disease in which a mutation exists in the gene for an ATP-dependent Ca 2+ transporter in Golgi bodies [3]. This disrupts intracellular Ca 2+ signaling. In this disease, flaccid blisters and erosions can be seen cutaneously. The most common places to find the blisters are the neck, axillae, and groin.
Linear Immunoglobulin A Bullous Dermatosis
Linear immunoglobulin A (IgA) bullous dermatosis is a group of subepidermal blistering diseases belonging to the pemphigoid group of diseases [3]. This disease occurs in both adults and children. In adults, the signs and symptoms of this disease are very similar to those in bullous pemphigoid. In children, this disease is given the term “chronic bullous disease of childhood” or CBDC. In children, this disease has blisters and erythema in a characteristic annular shape, found mainly in the groin, and on the thigh and lower trunk areas.
Transient Acantholytic Dermatosis (Grover’s Disease)
Grover’s disease mainly affects Caucasian males older than 40 years old and presents as itchy papulovesicular dermatitis, mainly on the trunk area and proximal extremities [3]. The pruritic nature of the dermatitis gets worse with sunlight exposure, heat, rubbing, and sweat.
Pemphigus Diseases
Pemphigus Vegetans
Pemphigus vegetans is a clinical variant of pemphigus vulgaris, which involves erosions that form fungoid or papillomatous growths [3]. These fungoid or vegetative growths are mainly seen on the scalp or face. This clinical variant is fairly rare and involves two subtypes: mild Hallopeau and severe Neumann types.