{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:54:31Z","timestamp":1790927671474,"version":"4.1.0"},"reference-count":8,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Dermatol"],"abstract":"<jats:p>&lt;p&gt;Introduction: Bullous pemphigoid (BP) is the most common autoimmune blistering disorder affecting the elderly population. While the etiology is predominantly idiopathic, physical trauma has been identified as a potential exacerbating factor. Most trauma-induced cases reported in the literature are associated with surgical incisions, burns, or open wounds. The development of generalized BP following a closed fracture, where the skin integrity remains initially intact, is an exceptionally rare phenomenon. The patient experienced a pre-bullous phase starting in June 2025, which significantly progressed to generalized BP following a closed radius fracture in October 2025. Case Report: We report the case of an 85-year-old woman who presented with a generalized blistering eruption 3 months after sustaining a closed fracture of the left radius. Physical examination revealed tense, fluid-filled bullae on an erythematous base involving the trunk and extremities. Histopathological analysis demonstrated a subepidermal blister with eosinophilic infiltration. The diagnosis was confirmed by direct immunofluorescence showing linear deposition of immunoglobulin G and C3 at the dermo-epidermal junction and enzyme-linked immunosorbent assay detecting high titers of anti-BP180 autoantibodies. The patient was treated with a tapering course of systemic prednisone, initiated at 90 mg\/day. This regimen led to the cessation of new blister formation within 2 weeks and complete clinical remission with normalization of inflammatory markers within 3 weeks. Conclusion: This case highlights that closed skeletal trauma, even without surgical intervention, can serve as a precipitating factor for generalized BP. The mechanism likely involves the release of sequestered antigens and epitope spreading due to internal tissue damage. Clinicians should maintain a high index of suspicion for BP in elderly patients presenting with cutaneous eruptions following orthopedic injuries to ensure prompt diagnosis and effective management. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000553401","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:00:40Z","timestamp":1786982440000},"page":"695-703","source":"Crossref","is-referenced-by-count":0,"title":["Exacerbation of Bullous Pemphigoid following a Closed Bone Fracture in an Elderly Patient: A Case Report"],"prefix":"10.1159","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7992-4470","authenticated-orcid":false,"given":"Dinara","family":"Azanbayeva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulfiya","family":"Jetpisbayeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akmaral","family":"Nurmukhambetova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issa Emir","family":"Ardakuly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torgyn","family":"Ibrayeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainur","family":"Botabaeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aizhan","family":"Shakhanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2018.00220"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pathol-012615-044313"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2012.35"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2004.02533.x"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09300.x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.129438"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04000-6"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.5114\/ada.2024.138825"}],"container-title":["Case Reports in Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000553401","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:17:31Z","timestamp":1790925451000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000553401"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000553401","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33270891","asserted-by":"subject"}]},"ISSN":["1662-6567"],"issn-type":[{"value":"1662-6567","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]}}}