Localized bullous pemphigoid in a patient with B-cell lymphoma

Bullous pemphigoid (BP) is an immunobullous disease characterized by circulating IgG antibodies directed towards cutaneous basement zone antigens. We report the case of a patient who had BP localized to a stoma site. At initial examination, a nodule was noted on the temple, which proved to be a large cell lymphoma, B-cell phenotype. On Western immunoblot, the patient's serum showed circulating IgG antibodies reactive with the 230 kDa BP antigen and the 97 kDa linear IgA bullous dermatosis antigen. The co-incident onset of the two diseases suggest that this may represent a case of paraneoplastic BP.