{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:08:46Z","timestamp":1792786126935,"version":"4.5.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Next Generation EU\u2014European Union","award":["CUP Master D13C22002810006"],"award-info":[{"award-number":["CUP Master D13C22002810006"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Bullous pemphigoid (BP) is the most common autoimmune blistering disorder in older patients and is typically managed with long-term immunosuppressive therapy tailored to the patient\u2019s comorbidities and overall health. Patients who are frail with concurrent haematological malignancies represent a particularly vulnerable population due to their impaired immunity and treatment-related immunosuppression. We report the case of an 85-year-old man with mantle cell lymphoma, previously treated with rituximab and ibrutinib, who developed BP confirmed by histology, direct immunofluorescence, indirect immunofluorescence and enzyme-linked immunosorbent assay. Initial disease control was achieved with systemic corticosteroids and methotrexate. Subsequently, he developed a subcutaneous thoracic nodule consistent with panniculitis, followed by cerebral nocardiosis and Pneumocystis jirovecii pneumonia. Despite successful remission of BP, his clinical course was complicated by life-threatening infections requiring prolonged hospitalization. This case highlights the delicate balance between controlling autoimmune disease and preventing severe opportunistic infections in older, frail patients with haematological malignancies. Current BP guidelines should be refined by integrating better frailty assessment, infection prophylaxis and tailored immunosuppressive strategies.<\/jats:p>","DOI":"10.1093\/skinhd\/vzag038","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T12:36:16Z","timestamp":1771936576000},"page":"571-574","source":"Crossref","is-referenced-by-count":0,"title":["Bullous pemphigoid in patients who are frail: a case complicated by cerebral nocardiosis and\n                    <i>Pneumocystis jirovecii<\/i>\n                    pneumonia"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5416-4392","authenticated-orcid":false,"given":"Simone","family":"Landini","sequence":"first","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Health Sciences, University of Florence , Florence 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,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Ruffo\u00a0di\u00a0Calabria","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Health Sciences, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Sanna","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Health Sciences, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Corti","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Health Sciences, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Volpi","sequence":"additional","affiliation":[{"name":"Immunopathology and Rare Skin Diseases Unit, Department of Health Sciences, Azienda USL Toscana Centro (ERN-SKIN), University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavinia","family":"Quintarelli","sequence":"additional","affiliation":[{"name":"Immunopathology and Rare Skin Diseases Unit, Department of Health Sciences, Azienda USL Toscana Centro (ERN-SKIN), University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffella","family":"Santi","sequence":"additional","affiliation":[{"name":"Section of Anatomic Pathology, Department of Health Sciences, Azienda USL Toscana Centro, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioia","family":"Di Stefano","sequence":"additional","affiliation":[{"name":"Section of Anatomic Pathology, Department of Health Sciences, Azienda USL Toscana Centro, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7471-3471","authenticated-orcid":false,"given":"Marzia","family":"Caproni","sequence":"additional","affiliation":[{"name":"Immunopathology and Rare Skin Diseases Unit, Department of Health Sciences, Azienda USL Toscana Centro (ERN-SKIN), University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Verdelli","sequence":"additional","affiliation":[{"name":"Immunopathology and Rare Skin Diseases Unit, Department of Health Sciences, Azienda USL Toscana Centro (ERN-SKIN), University of Florence , Florence 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