Bulloses Pemphigoid: Ungewohnlicher Minderbefall eines lymphodematosen Beines

We report the case of a 76-year-old patient with a histo- and immunologically diagnosed bullous pemphigoid. Clinically bullous skin lesions on erythematous areas were present. Histologically, characteristic subepidermal blisters with inflammatory infiltrates were found. Immunologically, a strong linear deposit of C3 at the basement membrane zone was seen and antibodies to the 180 kDa BP-antigen were detected by Western blot analysis in serum. Despite the generalized cutaneous disease a remarkably reduced manifestation of the right leg in association with chronic lymphedema was present. To our knowledge this association has never been described before. We postulate that the cutaneous and immunological alterations in chronic lymphedema prevented the manifestation of the bullous pemphigoid.