{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:10:46Z","timestamp":1753870246609,"version":"3.41.2"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T00:00:00Z","timestamp":1728691200000},"content-version":"vor","delay-in-days":1431,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Bullous pemphigoid (BP) appears to be rising in incidence across the Western World, especially in the elderly. Some of the pathogenetic mechanisms involving antigen mimicry and antibody cross-reactivity have been elucidated for cases associated with neurological disease and certain drugs. There have been reports of cutaneous manifestations of Covid-19 (SARS-Cov2 infection) as the pandemic has raged across the world. We report here a case of prolonged Covid-19, symptomatic with dermatoses only, which was seen to evolve initially from a maculo-papular exanthema with acral vesicular dermatitis, into classical BP disease. This was confirmed histologically by positive skin autoantibody serology, direct IMF on peri-lesional skin and also salt-split IMF. Although possible that the development of BP could be a purely co-incidental finding during Covid-19, we suggest that it is more likely that prolonged SARS-Cov2 infection triggered an autoimmune response to the basement membrane antigens, BP 180 and 230. To our knowledge, this is the first case of BP developing during concurrent Covid-19 disease. It will be necessary to continue dermatological surveillance as the pandemic continues, to collate data on BP incidence and to test these patients for Covid-19 disease. As the pandemic continues, even potential and rare associations such as this will be clarified eventually.<\/jats:p>\n               <jats:p>What's already known about this topic? \u00a0\u2022Covid-19 disease has been associated with a spectrum of dermatoses\u2022Common presentations in up to 20% of patients include exanthema, pseudo-chilblain like acral lesions \u2018Covid toes\u2019, livedo-\/retiform purpuric\/necrotic vascular lesions, acute urticarial lesions, and vesicular\/varicella-like lesions\u2022A multi-system inflammatory syndrome in children akin to Kawasaki syndrome has been described<\/jats:p>\n               <jats:p>What does this study add? \u00a0\u2022To our knowledge, this is the first description of classic Bullous Pemphigoid evolving from vesicular lesions caused by prolonged SARS-Cov2 induced skin inflammation<\/jats:p>","DOI":"10.1002\/ski2.6","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T05:20:14Z","timestamp":1605158414000},"source":"Crossref","is-referenced-by-count":6,"title":["Covid-19 Dermatoses: Acral Vesicular Pattern Evolving into Bullous Pemphigoid"],"prefix":"10.1093","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9940-7788","authenticated-orcid":false,"given":"P. K. C.","family":"Goon","sequence":"first","affiliation":[{"name":"Department of Dermatology, Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT) , Peterborough ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Bello","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT) , Peterborough ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. A.","family":"Adamczyk","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT) , Peterborough ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Y. H.","family":"Chan","sequence":"additional","affiliation":[{"name":"Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust , Cambridge ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Sudhoff","sequence":"additional","affiliation":[{"name":"University Hospital of Bielefeld , Bielefeld ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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