Development of Bullous Pemphigoid after Tenckhoff Catheter Placement in a Peritoneal Dialysis Patient

Abstract

Bullous pemphigoid (BP), a chronic autoimmune subepidermal blistering skin disease, has been described in end-stage renal disease patients requiring dialysis after the placement of an artero-venous fistula. We report a case of a novel onset of BP following a peritoneal dialysis abdominal Tenckhoff catheter placement. The 3-month treatment with systemic doxycycline and topical clobetasol propionate allowed a rapid disappearing of the blisters and left the patient free of symptoms in the follow-up. To our knowledge, this is the first case describing a new BP onset after a peritoneal dialysis catheter placement.

Blisters and Milia around the Peritoneal Dialysis Catheter: A Case of Localized Bullous Pemphigoid

“…In general, localized BP has a more benign disease course because it responds better to local treatments than the generalized form [ 25 ]. Moreover, the removal of the PD catheter was not required in our case or in the one described by Giunzioni [ 11 ]. Nevertheless, the localized disease may precede a diffuse involvement and a regular follow-up is necessary [ 25 ].…”

“…The onset of BP in patients receiving hemodialysis has been reported [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ], even in young patients [ 8 , 9 , 10 ], but the real incidence is unknown. In a few patients with an arteriovenous fistula (AVF) for hemodialysis access, the blisters have developed on the skin adjacent to the AVF [ 5 , 7 , 8 , 9 , 10 ], but BP lesions developed around PD catheter in only one case [ 11 ], as in our case.…”

Bullous pemphigoid in patients receiving peritoneal dialysis: a case series and a literature survey

“…14 and 17 and chronic scratching skin damage in Nos. 15 and 16) [ 16 ]. In the rest one case, phototoxicity of furosemide, followed by inflammatory skin damage, was a possible trigger of the onset (No.…”

“…The blisters evolve into eroded and crusted lesions and then heal with postinflammatory changes. Thus far, 12 cases of BP have been reported in patients receiving hemodialysis (HD) [ 4–14 ], and only two in patients receiving peritoneal dialysis (PD) [ 15 , 16 ]. Recently, we experienced three cases of BP in our PD patients.…”

Severe Bullous Pemphigoid Onset after Jugular Catheter Placement in a Patient on Hemodialysis

“…The association of BP with renal insufficiency, renal transplantation, or dialysis is not common. There are few reports on this association in the literature for patients requiring dialysis after the placement of an arteriovenous fistula (AVF) [ 4 , 5 , 6 , 7 , 8 ] or, more recently, after the placement of a peritoneal catheter [ 9 ]. We report a case of severe BP associated with jugular catheter placement in a hemodialysis patient.…”