Bullous pemphigoid: From the clinic to the bench

Bullous pemphigoid. A and B, Erythematous urticarial and infiltrated plaques with tense vesicles, blisters, erosions, and crusts on the trunk. C, Close view of tense serous blisters arising on infiltrated plaques of the thigh. D, Localized bullous pemphigoid on the left foot.

Bullous pemphigoid: the early stage forms without frank blistering and variants. A, Prurigo-like lesions on the left arm and trunk, with infiltrated urticarial plaques on the trunk. B, Extensive infiltrated urticarial lesions on the trunk and right arm. C, Excoriated eczematous lesions on the right arm and shoulder. D, Localized dyshidrosiform variant on the right foot.

Diagnostic algorithm for bullous pemphigoid (BP). ELISA, enzyme-linked immunosorbent assay; FOAM, fluorescence overlay antigen mapping; IgG, immunoglobulin G.

The epidermal basement membrane zone (BMZ). The diagram depicts the major components of the dermal–epidermal junction. The components include the keratin filaments, the hemidesmosomal proteins, and the extracellular matrix proteins, such as laminin 332. Bullous pemphigoid (BP) BP180 and BP230 are components of hemidesmosomes, junctional complexes promoting adhesion of epithelial cells to the underlying basement membrane zone in stratified and other complex epithelia, such as skin and mucous membranes.