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Lichen Planus Pemphigoides Mimicking Toxic Epidermal Necrolysis

Ondhia, Chandni MRCP*; Kaur, Charanjit FRCPath; Mee, John PhD; Natkunarajah, Janakan FRCP§; Singh, Manuraj PhD

The American Journal of Dermatopathology: November 2019 - Volume 41 - Issue 11 - p e144–e147
doi: 10.1097/DAD.0000000000001461
Extraordinary Case Report
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Abstract: Lichen planus pemphigoides (LPP) is an immunobullous disorder characterized by a combination of lesions resembling bullous pemphigoid and lichen planus (LP). Immunofluorescence studies typically show linear deposition of IgG and C3 along the basement membrane zone and circulating antibodies to the hemidesmosome protein BP180 also known as type XVII collagen. It is now recognized that drug-induced linear IgA disease may present with lesions mimicking toxic epidermal necrolysis (TEN). However, to date, there have been no reported cases of LPP presenting with TEN-like lesions. This report describes a 70-year-old woman with LPP who presented with extensive erosions mimicking TEN. This case also highlights the need to consider important etiologies such as drug-induced and paraneoplastic LPP.

Departments of *Dermatology, and

Cellular Pathology, St. George's University Hospital, London, United Kingdom;

Immunodermatology Laboratory, St John's Institute of Dermatology, St Thomas' Hospital, London, United Kingdom; and

§Department of Dermatology, Kingston Hospital, Kingston upon Thames, United Kingdom.

Correspondence: Manuraj Singh, Department of Cellular Pathology, St. George's University Hospital, Blackshaw Road, London SW17 0QT, United Kingdom (e-mail: masingh@doctors.org.uk).

The authors declare no conflicts of interest.

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