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Bullous Pemphigoid in Otolaryngology: Case Report

Andre Carcao*, Catarina Rato, Nuno Trigueiros-Cunha, Delfm Duarte, Marta Neves

Bullous pemphigoid is a disease of the sub epithelial layer of the skin of autoimmune etology that ofen appears in elderly individuals and is characterized by the presence of cutaneous bullous lesions and erosions of the mucous membranes. The inital presentaton of a case of bullous pemphigoid in otorhinolaryngology is described. A 70-year-old man resorts to an otolaryngology consultaton for an history of odynophagia and pharyngeal foreign body sensaton with four months of evoluton. Concomitantly, he complained of severe itching related to the appearance of skin lesions. Physical examinaton revealed ulcerated lesions of the palate, tongue base and pharynx. Naso fbroscopy was performed, and mucous granulaton was observed in the right nasal cavity and hypo pharynx as well as larynx edema. The rest of the body had erythematous skin lesions in the region of the thighs and armpits as well as ?uid-flled, tense blisters with regular-sized borders compatble with the bullous pemphigoid. The patho physiological mechanisms responsible for pemphigoid lesions are not fully understood, but it's thought to be related to antbody-mediated basement membrane epithelial lesion. Usually, the manifestatons in the mucous membranes improve with systemic treatment insttuted to treat the skin lesions. The clinical course of these lesions is variable, generally following a relapsing chronic patern controlled by cortcotherapy. Long-term remission may occur afer months or years.