Abstract
A 56-year-old Japanese man, who had been treated for nodular prurigo, developed blisters on the pruritic nodules and erythemas 6 months after cryotherapy. Biopsy from the skin lesion disclosed parakeratosis, hyperkeratosis, acanthosis of the epidermis, and subepidermal blister. Direct immunofluorescence study showed a linear deposition of IgG and C3 on dermo-epidermal junction. On immunoblot analysis, his serum reacted with BP230 in the epidermal extracts, as well as the recombinant protein of BP180 NC16a domain. Based on these clinical, histopathological and immunological findings, we diagnosed this case pemphigoid nodularis. Betamethasone, minocycline and nicotinamide quickly improved his symptoms.
