Bullous pemphigoid associated with milia,increased serum IgE,autoantibodies against desmogleins,and refractory treatment in a young patient

Bullous pemphigoid is a blistering autoimmune disease characterized by two hemidesmosomal proteins (anti-bp180 and 230). pemphigus,by contrast,is characterized by two autoantibodies (anti-desmoglein 1 and 3). coexistence of autoantibodies of bullous pemphigoid and pemphigus in a patient is rare. a 25-year-old male patient was admitted to our hospital,reporting a 3-month history of multiple papules,vesicles,and erosions over an extensive erythema on the entire body. laboratory tests showed high levels of serum ige,anti-bp180 antibodies,and anti-desmoglein 1 and 3. histopathologic and immunopathologic features were characterized by bullous pemphigoid. no improvement was seen with systemic corticosteroid therapy,however,pulse corticosteriod therapy combined with methylprednisolone,immunosuppressants,immunomodulators,and plasmapheresis led to the recovery of his condition with numerous milia. © 2017 by anais brasileiros de dermatologia.