Localized bullous pemphigoid. A mimic of acute contact dermatitis.

A case of localized bullous pemphigoid that mimicked an acute contact dermatitis around a stoma site is presented. The diagnosis was confirmed by direct immunofluorescence and by indirect immunofluorescence on 1.0 mol/L of sodium chloride split skin. A review of the literature demonstrates 30 previous well-documented cases of localized bullous pemphigoid. As in our case, local factors such as trauma, ultraviolet light, or topical therapy seem to be frequently implicated in the production of lesions. The possibility that these patients might otherwise have subclinical bullous pemphigoid was considered. The disease has a benign course and generally responds to cessation of exacerbating factors and initiation of topical steroid therapy.