Postpartum bullous pemphigoid – A case report

Bullous pemphigoid (BP) is an acquired autoimmune blistering disease occurring in the elderly more than 70 years of age though may occur during young age and childhood. BP is categorized by the development of urticarial plaques surmounted by sub epidermal blisters, and the deposition of immunoglobulin and complement at the basement membrane zone (BMZ) of the skin. BP is associated with other diseases, such as diabetes mellitus, thyroid disorders, rheumatoid arthritis and malignancies. Heat shock proteins (HSP) are a family of proteins that are produced by cells in response to exposure to stressful conditions. Heat shock protein 90 (HSP90) inhibitors potentially target for the autoimmune disease and chronic inflammatory diseases. We present a case of 21 year old lactating female, a known case of hyperthyroidism with an abrupt onset of fluid filled vesicles and bullae over the abdomen and limbs since 3 days associated with itching. She had similar episodes before and was diagnosed and treated for BP. She had a flare up of the disease due to the personal stress in the patient as Heat shock proteins plays an important role in the pathophysiology of BP. Following treatment upon continuous follow ups, there were no flare up of the disease. Here in this patient, apart from hypothyroidism, stress also acts as a trigger in BP.