Bullous pemphigoid following adjuvant radiotherapy for breast cancer: a case report.
Daniel Walipour, Rafaela Höfler, Elena Scharner et al.
✦ AI-curated · Sources linked
Case in brief
An 85-year-old woman developed intensely pruritic blisters about 7 weeks after adjuvant radiotherapy for right breast cancer. Lesions began on the irradiated breast and later involved the upper arm and back; the initial impression was late radiation dermatitis. Biopsy showed subepidermal blistering with inflammatory infiltrates, direct immunofluorescence showed linear IgG and C3 at the basement membrane zone, and serology found elevated BP230 antibodies, confirming bullous pemphigoid. High-potency topical corticosteroids and systemic doxycycline were followed by marked clinical improvement.
What made this case unusual
The delayed blistering initially resembled radiation dermatitis, but spread beyond the irradiated breast and proved to be bullous pemphigoid.
Diagnostic / clinical pearl
When blistering begins outside the typical timeframe of radiodermatitis or progresses beyond the treated area, consider autoimmune blistering disease and pursue diagnostic evaluation, including immunofluorescence and serology.