Case report on localized bullous pemphigoid in two young females

Bullous pemphigoid (BP) is a chronic autoimmune bullous eruption that is characterized by pruritic, tense sub-epidermal bullae. It commonly affects those aged 60 years and above. It has no gender predilection. It can be generalized or localized. This is a case report of 2 female patients with localized BP presenting as recurrent skin rash of more than 1 year duration which were later referred to the dermatology clinic. The patients were both females less than 40 years of age who have been having recurrent skin rash that have been associated with intense itching localized to a unilateral lower limb. The first patient had obvious bullae and ulcers while the second didn’t have any obvious bullae. Initial clinical diagnoses did not consider BP. Punch skin biopsy was done in both cases that revealed histologic features confirming BP. Clinicians should have high index of suspicion of BP even in cases of localized chronic wound or recurrent ulcers irrespective of the age of patient.