2018 Volume 35 Issue 4 Pages 610-614
The patient is a 66-year-old woman who experienced skin eruption and associated itching on the left side of the umbilicus 5 months before the initial visit. In the following month, the patient presented to a nearby clinic, and an antibacterial drug was administered; however, no improvement was observed, and she visited our hospital with a referral. A tense blister and associated itching were observed on the left side of the umbilicus. Although the patient did not have relevant history and was not previously administered PRN drugs, nutritional supplements, or dipeptidyl peptidase-4 -4 inhibitors, fixed drug eruption was suspected on the basis of the clinical findings. Laboratory examination indicated increased eosinophil levels and positivity for anti-BP180 antibodies. Histological findings indicated the formation of a subepidermal blister and infiltration of eosinophils into the blister and the dermis. Application of the direct immunofluorescence technique revealed linear deposition of IgG and C3 in the epidermal basement membrane. These results led to a diagnosis of localized pemphigoid at the umbilical region. The patient was treated with topical application of a steroid ointment as well as oral administration of tetracycline and nicotinic-acid amide and is recovering. In many cases, dyshidrosiform pemphigoid that is localized in the palm of the hand or on the sole of the foot spreads to the entire body. Although, according to reports, localized pemphigoid developed at other sites mostly remains localized, a careful follow-up of the patient is being performed.