Skip to main content

Bullous Pemphigoid on the Areola of Breast

  • Chapter
  • First Online:
  • 919 Accesses

Abstract

Bullous pemphigoid is the most common autoimmune bullous disease. It usually appears as a very itchy rash of urticarial or eczematous appearance, with subsequent appearance of vesicles and tense blisters on previously inflamed skin. The basis of its pathogenesis consists of the production of autoantibodies that attacks several components of the hemidesmosomes which are located in the basal membrane of the dermoepidermal junction. Localized bullous pemphigoid is a rare clinical variant of bullous pemphigoid. It normally appears in the lower extremities and it’s rarer on palms or on the breast. Several causes have been described, such as physical trauma, ultraviolet radiation, and, in the case of localized bullous pemphigoid on the breast, radiotherapy or ductal carcinoma, although it is not always possible to find an underlying cause.

This is a preview of subscription content, log in via an institution.

References

  1. Mutasim DF. Autoimmune bullous dermatoses in the elderly: an update on pathophysiology, diagnosis and management. Drugs Aging. 2010;1:1–19.

    Article  Google Scholar 

  2. Isohashi F, Konishi K, Umegaki N, Tanei T, Koizumi M, Yoshioka Y. A case of bullous pemphigoid exacerbated by irradiation after breast conservative radiotherapy. Jpn J Clin Oncol. 2011;41(6):811–3.

    Article  PubMed  Google Scholar 

  3. Mul VE, van Geest AJ, Pijls-Johannesma MC, Theys J, Verschueren TA, Jager JJ, et al. Radiation-induced bullous pemphigoid: a systematic review of an unusual radiation side effect. Radiother Oncol. 2007;82:5–9.

    Article  PubMed  Google Scholar 

  4. Mul VE, Verschueren TA, van Geest AJ, Baumert BG. Bullous Pemphigoid (BP) induced by radiotherapy. Radiother Oncol. 2007;82:105.

    Article  PubMed  Google Scholar 

  5. Anzai S, Ueo D, Fujiwara S. A case of bullous pemphigoid exacerbated by radiotherapy. Vis Dermatol. 2009;8:32–3.

    Google Scholar 

  6. Weiss G, Shemer A, Trau H. The Koebner phenomenon: review of the literature. J Eur Acad Dermatol Venereol. 2002;16:241–8.

    Article  PubMed  CAS  Google Scholar 

  7. Luliano L, Micheletta F, Natoli S. Bullous pemphigoid: an unusual and insidious presentation of breast cancer. Clin Oncol. 2003;15(8):505.

    Google Scholar 

  8. Vaughan Jones SA, Salas J, McGrath JA, Palmer I, Bhogal GS, Black MM. A retrospective analysis of tissue-fixed immunoreactants from skin biopsies maintained in Michel’s medium. Dermatology. 1994;189(Suppl 1):131–2.

    Article  PubMed  Google Scholar 

  9. Yancey KB, Egan CA. Pemphigoid: clinical, histologic, immunopathologic, and therapeutic considerations. JAMA. 2000;284:350–6.

    Article  PubMed  CAS  Google Scholar 

  10. Iwata Y, Komura K, Kodera M, Usuda T, Yokoyama Y, Hara T, Muroi E, Ogawa F, Takenaka M, Sato S. Correlation of IgE autoantibody to BP180 with a severe form of bullous pemphigoid. Arch Dermatol. 2008;144:41–8.

    Article  PubMed  CAS  Google Scholar 

  11. Westerhof W. Treatment of bullous pemphigoid with topical clobetasol propionate. J Am Acad Dermatol. 1989;20:458–61.

    Article  PubMed  CAS  Google Scholar 

  12. Ingen-Housz-Oro S, Valeyrie-Allanore L, Ortonne N, Roujeau JC, Wolkenstein P, Chosidow O. Management of bullous pemphigoid with topical steroids in the clinical practice of a single center: outcome at 6 and 12 months. Dermatology. 2011;222:176–9.

    Article  PubMed  CAS  Google Scholar 

  13. Morel P, Guillaume JC. Treatment of bullous pemphigoid with prednisolone only: 0.75 mg/kg/day versus 1.25 mg/kg/day. A multicenter randomized study. Ann Dermatol Venereol. 1984;111:925–8.

    PubMed  CAS  Google Scholar 

  14. Venning VA, Millard PR, Wojnarowska F. Dapsone as first line therapy for bullous pemphigoid. Br J Dermatol. 1989;120:83–92.

    Article  PubMed  CAS  Google Scholar 

  15. Fivenson D, Breneman D, Rosen G, Hersh CS, Cardone S, Mutasim D. Nicotinamide and tetracycline therapy of bullous pemphigoid. Arch Dermatol. 1994;130:753–8.

    Article  PubMed  CAS  Google Scholar 

  16. Kirtschig G, Khumalo NP. Management of bullous pemphigoid: recommendations for immunomodulatory treatments. Am J Clin Dermatol. 2004;5:319–26.

    Article  PubMed  Google Scholar 

  17. Heilborn JD, Ståhle-Bäckdahl M, Albertioni F, Vassilaki I, Peterson C, Stephansson E. Low-dose oral pulse methotrexate as monotherapy in elderly patients with bullous pemphigoid. J Am Acad Dermatol. 1999;40:741–9.

    Article  PubMed  CAS  Google Scholar 

  18. Burton JL, Harman RR, Peachey RD, Warin RP. Azathioprine plus prednisone in treatment of pemphigoid. Br Med J. 1978;28:1190–1.

    Article  Google Scholar 

  19. Grundmann-Kollmann M, Korting HC, Behrens S, Kaskel P, Leiter U, Krähn G, Kerscher M, Peter RU. Mycophenolate mofetil: a new therapeutic option in the treatment of blistering autoimmune diseases. J Am Acad Dermatol. 1999;40(6 Pt 1):957–60.

    Article  PubMed  CAS  Google Scholar 

  20. Lourari S, Herve C, Doffoel-Hantz V, Meyer N, Bulai-Livideanu C, Viraben R, Maza A, Adoue D, Bedane C, Paul C. Bullous and mucous membrane pemphigoid show a mixed response to rituximab: experience in seven patients. J Eur Acad Dermatol Venereol. 2011;25:1238–40.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Álvaro Vargas Nevado M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Nevado, Á.V., Ceballos, E.H. (2018). Bullous Pemphigoid on the Areola of Breast. In: Shiffman, M. (eds) Nipple-Areolar Complex Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-60925-6_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-60925-6_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60924-9

  • Online ISBN: 978-3-319-60925-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics