Bullous pemphigoid in an elderly patient with myelodysplastic syndrome and refractory anemia coupled with excess of blast.

Bullous pemphigoid (BP) has a recognized association with solid organ tumors, but is relatively rare in hematological malignancies. We report a 67-year-old male who developed BP after being diagnosed with myelodysplastic syndrome and refractory anemia with excess of blast (RAEB). Skin biopsy elucidated sub-epidermal bulla using direct immunofluorescence, revealing linear C3 and IgG deposits along the basement membrane. His BP was recalcitrant to the conventional treatment and only responded to a combination of high dose oral prednisolone and azathioprine. The relative refractory nature of his condition and concurrent RAEB supports a paraneoplastic nature.

Citation

Yin Yin Lee, Ping Chong Bee, Chew Kek Lee, Manimalar Naiker, Rokiah Ismail. Bullous pemphigoid in an elderly patient with myelodysplastic syndrome and refractory anemia coupled with excess of blast. Annals of dermatology. 2011 Dec;23(Suppl 3):S390-2

PMID: 22346286

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