Prolonged pruritus and bullous pemphigoid

Summary We report eight elderly patients with atypical bullous pemphigoid in whom prolonged pruritus (mean 10 months) preceded the making of the diagnosis of bullous pemphigoid. In three patients blisters were not seen clinically but histological and immunofluorescent examinations confirmed the diagnosis. All but one patient had IgG antibasement membrane antibody detected in their sera by the indirect immunofluorescent technique. However, detection of this antibody is not a useful tool in diagnosing these pruritic patients with bullous pemphigoid as 45% of patients with antibasement membrane antibody in their sera were found to be suffering from other dermatoses.