Clinical cases


Epidermolysis bullosa acquisita is a rare autoimmune bullous disease, with the development of autoantibodies directed against type VII collagen. Cutaneous manifestations are heterogeneous and may be common to other bullous diseases. The classic presentation is that of a noninflammatory mechanobullous disease characterized by the development of acral blisters that occur with minor trauma and that heal with atrophic scarring, milia formation, and pigmentation changes. Skin biopsy and serologic tests are necessary to confirm the diagnosis and treatment is difficult and often unsatisfactory. We present the case of a 71-year-old female patient who was admitted to our clinic for the presence of erythematous-petechial and vesiculo-bullous lesions, which occur spontaneously or after minor trauma, disseminated throughout the body, with an evolution of over 3 years. Histopathological examinations were not specific to epidermolysis bullosa, although the clinical examination was highly suggestive. After therapeutic failure with Colchicine and Dapsone, it was decided to start treatment with Medrol with a favorable outcome after one month of treatment. Although the diagnostic criteria are not defined the clinical aspects and the evolution under corticosteroid treatment support the diagnosis of epidermolysis bullosa acquisita.