Suprabasal Blistering as a Diagnostic Pitfall in Bullous Pemphigoid: Histopathologic-Immunofluorescence Discordance Complicated by Sepsis. (PubMed, Cureus) - Oct 4, 2026 - "The patient also developed progressive multifactorial anemia, sepsis-associated coagulopathy, and upper gastrointestinal bleeding. Following multidisciplinary management, she achieved near-complete resolution of skin lesions and clinical recovery, and was discharged with plans for rituximab as definitive steroid-sparing therapy. This case highlights two critical lessons: first, a suprabasal blister on histopathology does not exclude bullous pemphigoid, as re-epithelialization can alter the apparent cleavage plane, making DIF indispensable for an accurate diagnosis; second, severe bullous pemphigoid requiring intensive immunosuppression carries a substantial risk of sequential nosocomial infections warranting close microbiological surveillance, early source control, and timely modulation of immunosuppressive regimens."
Journal • Bullous Pemphigoid • Dermatology • Dermatopathology • Diabetes • Diabetic Neuropathy • Gastroenterology • Hematological Disorders • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Pain • Pemphigus Vulgaris • Pneumonia • Respiratory Diseases • Septic Shock • Type 2 Diabetes Mellitus
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Adriana V Saenz; Anna K Bustillos; Marisol Cazares; Mauro A Cardenas; Sarahi G Romero; Sofia de La O
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