Abstract
A 75-year-old female patient visited our hospital with itchy erythema and blisters on the trunk and extremities for about 2 weeks. Histopathological examination revealed a subepidermal blister and immunofluorescence study showed C3 deposit on the basal membrane. Serum level of anti-BP180 antibody was high. We diagnosed bullous pemphigoid (BP) and commenced oral prednisone therapy (40mg/day). On the 7th day of treatment, she vomited a cast of esophageal mucosa with blood and food. Gastric endoscopy revealed exfoliative esophagitis on the entire esophagus developing toward the esophagogastric junction. Both esophageal and cutaneous lesions were improved in 2 weeks by steroid pulse therapy. Exfoliative esophagitis has been infrequently reported in BP and esophagitis dissecans superficialis is a rare involvement. Our case suggests that the possibility of esophageal mucosal involvement should be considered in the differential diagnosis.
