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Split Skin Grafting Precipitated Bullous Pemphigoid
Bullous pemphigoid (BP) is an autoimmune subepidermal blistering dermatological condition that can be triggered by several external factors. Here, we present a case of an immunocompetent patient with no prior dermatological history, who developed BP as a result of autologous skin graft surgery. It i...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850676/ https://www.ncbi.nlm.nih.gov/pubmed/35198718 http://dx.doi.org/10.1016/j.jpra.2021.12.002 |
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author | Gohil, K. Moore, A. Jaffe, W. |
author_facet | Gohil, K. Moore, A. Jaffe, W. |
author_sort | Gohil, K. |
collection | PubMed |
description | Bullous pemphigoid (BP) is an autoimmune subepidermal blistering dermatological condition that can be triggered by several external factors. Here, we present a case of an immunocompetent patient with no prior dermatological history, who developed BP as a result of autologous skin graft surgery. It is an uncommon surgical complication and was most likely triggered by the trauma of the surgery itself. Our patient's bullae first developed a month after his surgery at both surgical sites and subsequently became widespread. The diagnosis was confirmed histologically using punch biopsies of a bulla and the perilesional skin for direct immunofluorescence together with indirect immunofluorescence of the serum for anti-skin antibodies. Initial topical treatment and regular wound care were not improving the patient's condition at a satisfactory rate. Therefore, the patient was started on systemic steroids, which unfortunately resulted in a presumed split skin graft infection requiring admission. After histological diagnosis confirmation was achieved, the Dermatology team formulated a treatment plan, which combined both topical and systemic medication. The patient is currently making a good recovery and the graft loss resulting from the condition is only partial, requiring no further surgery. We present this case as a reminder to all clinicians that, although rare, BP can be triggered by skin grafting, even in patients with no prior history of it or any predisposing conditions. This autoimmune condition needs to be recognised and treated promptly to ensure optimal clinical outcomes and minimise graft loss. |
format | Online Article Text |
id | pubmed-8850676 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-88506762022-02-22 Split Skin Grafting Precipitated Bullous Pemphigoid Gohil, K. Moore, A. Jaffe, W. JPRAS Open Case Report Bullous pemphigoid (BP) is an autoimmune subepidermal blistering dermatological condition that can be triggered by several external factors. Here, we present a case of an immunocompetent patient with no prior dermatological history, who developed BP as a result of autologous skin graft surgery. It is an uncommon surgical complication and was most likely triggered by the trauma of the surgery itself. Our patient's bullae first developed a month after his surgery at both surgical sites and subsequently became widespread. The diagnosis was confirmed histologically using punch biopsies of a bulla and the perilesional skin for direct immunofluorescence together with indirect immunofluorescence of the serum for anti-skin antibodies. Initial topical treatment and regular wound care were not improving the patient's condition at a satisfactory rate. Therefore, the patient was started on systemic steroids, which unfortunately resulted in a presumed split skin graft infection requiring admission. After histological diagnosis confirmation was achieved, the Dermatology team formulated a treatment plan, which combined both topical and systemic medication. The patient is currently making a good recovery and the graft loss resulting from the condition is only partial, requiring no further surgery. We present this case as a reminder to all clinicians that, although rare, BP can be triggered by skin grafting, even in patients with no prior history of it or any predisposing conditions. This autoimmune condition needs to be recognised and treated promptly to ensure optimal clinical outcomes and minimise graft loss. Elsevier 2021-12-18 /pmc/articles/PMC8850676/ /pubmed/35198718 http://dx.doi.org/10.1016/j.jpra.2021.12.002 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Gohil, K. Moore, A. Jaffe, W. Split Skin Grafting Precipitated Bullous Pemphigoid |
title | Split Skin Grafting Precipitated Bullous Pemphigoid |
title_full | Split Skin Grafting Precipitated Bullous Pemphigoid |
title_fullStr | Split Skin Grafting Precipitated Bullous Pemphigoid |
title_full_unstemmed | Split Skin Grafting Precipitated Bullous Pemphigoid |
title_short | Split Skin Grafting Precipitated Bullous Pemphigoid |
title_sort | split skin grafting precipitated bullous pemphigoid |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850676/ https://www.ncbi.nlm.nih.gov/pubmed/35198718 http://dx.doi.org/10.1016/j.jpra.2021.12.002 |
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