A case of anti-p200 pemphigoid clinically mimicking inflammatory epidermolysis bullosa acquisita

Sir, Anti‐p200 pemphigoid is a new disease entity, which was first described in 1996 by Hashimoto's group.1, 2 They described an unusual case with autoimmune subepidermal bullous lesions that clinically resembled bullous pemphigoid1 and a case with psoriasis vulgaris that developed extensive blister formation.2 Both the nonpsoriatic patient and the psoriatic patient were characterized by immunoglobulin (Ig)G autoantibodies against a novel 200‐kDa lower lamina lucida component. To date, anti‐p200 pemphigoid has been shown to present various clinical features. This new autoimmune bullous disease seems to be classified into three clinical forms: (i) coexistence with psoriasis,2, 3 (ii) presenting the clinical features of vesicular pemphigoid,4 and (iii) presenting clinically atypical blistering features.1, 5 In this report, we describe a new patient with anti‐p200 pemphigoid clinically mimicking inflammatory epidermolysis bullosa acquisita (EBA). A 28‐year‐old Japanese male was referred to us because of numerous pruritic bullous skin lesions on the entire body of 2 weeks' duration. Neither he nor his family had a past history of psoriasis. On physical examination, large, tense bullae and vesicles with erythema, and erosions similar to the skin lesions of bullous pemphigoid were found on his entire body (Fig. 1). The blisters tended to form in an annular arrangement resembling linear IgA bullous dermatosis or dermatitis herpetiformis. Oral and genital mucosae were not involved.