A 85-year-old female developed multiple blisters on trunk and thigh. Nikolsky's sign negative. The lesions came on and off. The most probable diagnosis is:
Elderly patient, -ve nikolsky sign and multiple blisters on trunk and thigh point towards BP Other features BP AI subepidermal blistering disease. MHC II - HLA-DQ1*0301 is prevalent. Oral mucosal lesions are found rarely (10-40%) Pruritus +/- Nontraumatized blisters heal without scarring Tense blisters-->rupture--> flaccid lesions/ erosions+/- surmounting crust Rx: Mainstay- systemic glucocoicoids -Prednisone, 40 to 60 mg/d.(good response) Azathioprine (1-2 mg/kg/day), Mycophenolate mofetil (20-35mg/kg/day), or Cyclophosphamide (1-2 mg/kg/day)
Pemphigus vulgaris
Bullous pemphigoid
Lichen planus
Lepra reaction
Blistering disorders