Journal of

Background and Aim: Bullous pemphigoid (BP) is an acquired autoimmune disease with subepidermal blisters commonly seen in the elderly over 60 years. Although the disease is usually manifested with tense blisters, but in some cases generalized pruritus is the only symptom of disease, which is less studied.

Methods: In a retrospective study, the medical records of 416 BP patients confirmed in pathology laboratory were evaluated for clinical findings, direct immunofluorescence (DIF) testing for BMZ-binding IgG antibodies and histological findings.

Results: Of the 416 confirmed BP patients, 213 were male and 203 were female. The mean age of patients was 64.36 years. Thirty four patients at the onset of the disease had generalized pruritus, which in the course of the disease, 29 patients also showed other symptoms of the disease. In 5 patients generalized pruritus was seen as the only symptom. Concerning to the results of DIF, 117 (90%) patients showed autoantibody deposit, and in 13 (10%) patients the test was negative. There was no significant relationship between DIF results and histological findings (p> 0.05).

Conclusion: According to the findings of this study, generalized pruritus is uncommon as the first symptom of the disease. There was not any association between generalized pruritus and histological observations including dermal edema, presence of eosinophils in tissue, subepidermal blister as well as DIF results. Further studies on the early detection of the disease are required to decrease complications of the disease.