2026-04-05T10:52:48Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/109072025-10-24T10:59:41Zcom_2072_451665com_2072_378040col_2072_451666

Case Report: Localized bullous pemphigoid induced by local triggers: a case series and a proposal for diagnostic criteria based on a literature review Corbella-Bagot, Lluís Gil-Lianes, Javier Fernández-Vela, Javier Marti-Marti, Ignasi Alegre Fernandez, Marta FUERTES DE VEGA, IRENE Garbayo-Salmons, Patricia Bosch-Amate, Xavier Guilabert, Antonio Pell - Malalties Radioteràpia DISEASES::Skin and Connective Tissue Diseases::Skin Diseases::Skin Diseases, Vesiculobullous::Pemphigoid, Bullous ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Radiotherapy PUBLICATION CHARACTERISTICS::Publication Formats::Journal Article::Review ENFERMEDADES::enfermedades de la piel y tejido conjuntivo::enfermedades de la piel::enfermedades cutáneas vesiculoampollosas::penfigoide ampolloso TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::radioterapia CARACTERÍSTICAS DE PUBLICACIONES::formatos de publicación::artículo de revista::revisión Bullous pemphigoid; Radiotherapy; Case report Penfigoide ampolloso; Radioterapia; Reporte de un caso Penfigoide bullós; Radioteràpia; Informe d'un cas Introduction: Localized bullous pemphigoid (LBP) is an infrequent bullous pemphigoid (BP) variant restricted to a body region. According to the most compelling evidence, LBP occurs in patients with pre-existent serum antibodies against the basement membrane zone, which occasionally acquire the capacity to induce disease after the influence of different local factors acting as triggers. Methods: We hereby present a multicenter cohort of 7 patients with LBP developed after local triggers: radiotherapy, thermal burns, surgery, rosacea, edema and a paretic leg. In addition, we conducted a review of the literature, and we propose a set of diagnostic criteria for LBP, also based on our case series and the 2022 BP guidelines from the European Academy of Dermatology and Venereology. Results: During follow-up, three of the patients from our series evolved to a generalized BP, with only one requiring hospitalization. Our literature search retrieved 47 articles including a total of 108 patients with LBP, with a 63% with a potential local precipitating factor previous to their diagnosis. LBP mostly affected older females, and a subsequent generalized progression occurred in 16.7% of the cases. The most frequently involved areas were the lower limbs. Radiation therapy and surgery were responsible for the inducement of nearly 2 in 3 cases of LBP. We observed a significantly higher risk of generalization in cases where the trigger led to the developing of LBP earlier (p=0.016). Our statistical analysis did not detect any other prognosis factor for generalization when assessing direct immunofluorescence, histological and serological results, or other patient related factors. Conclusion: LBP should be suspected in patients with recurrent localized bullous eruptions. The presence of a trauma history in the same anatomic area is reported in most cases. 2025-10-24T10:59:41Z 2025-10-24T10:59:41Z 2024-01-25T13:04:17Z 2024-01-25T13:04:17Z 2023-06-02 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/10907 Frontiers in immunology;14 https://doi.org/10.3389/fimmu.2023.1160779 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Frontiers Media Scientia