Esophageal Nikolsky’s Sign: A Rare Finding in a Patient with Bullous Pemphigoid

Ghoneim, Sara; Shah, Aun R.; Calderon, Amy

doi:10.1159/000503898

Cited by 5 publications

(13 citation statements)

References 15 publications

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“…107,108,110,111 Bulla formation following contact with the endoscope has also been reported in one case, a finding which represents Nikolsky's sign. 109,110 Histopathologically, the oesophageal lesion closely resembles cutaneous findings. There may partial or complete detachment of the surface epithelium, with subepidermal bulla formation.…”

Section: B U L L O U S P E M P H I G O I Dmentioning

confidence: 65%

“…The mucosa may be friable and slough away 107,108,110,111 . Bulla formation following contact with the endoscope has also been reported in one case, a finding which represents Nikolsky’s sign 109,110 . Histopathologically, the oesophageal lesion closely resembles cutaneous findings.…”

Section: Cutaneous Diseases Which Affect the Oesophagusmentioning

confidence: 76%

“…When present, symptoms include dysphagia, epigastric pain, haematemesis and melaena, which occurs due to the presence of haemorrhagic bullae. 110 Some patients with severe endoscopic disease can be asymptomatic. 111 Endoscopically, the oesophagus shows bullae of varying size, some of which may contain haemorrhagic contents.…”

Section: B U L L O U S P E M P H I G O I Dmentioning

confidence: 99%

“…Treatment is with systemic steroids initially with or without additional topical steroids 107,108 . Most patients respond well to steroid therapy 107,108,110,111 …”

Section: Cutaneous Diseases Which Affect the Oesophagusmentioning

confidence: 99%

“…Clinically, oesophageal involvement by bullous pemphigoid manifests in a non‐specific fashion. When present, symptoms include dysphagia, epigastric pain, haematemesis and melaena, which occurs due to the presence of haemorrhagic bullae 110 . Some patients with severe endoscopic disease can be asymptomatic 111 .…”

Section: Cutaneous Diseases Which Affect the Oesophagusmentioning

confidence: 99%

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Novel and rare forms of oesophagitis

Malone

Sheahan

2020

Histopathology

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Our understanding of inflammatory diseases of the gastrointestinal tract, including those of the oesophagus, has expanded in recent years. Once attributed almost exclusively to gastro‐oesophageal reflux disease or infection, it is now recognised that oesophagitis may occur due to a variety of distinct disease entities. Many of these conditions cause debilitating and persistent symptoms, impacting upon quality of life and necessitating ongoing surveillance and treatment. This review will consider the clinical, endoscopic and histopathological features of these novel and rare forms of oesophagitis.

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Section: B U L L O U S P E M P H I G O I Dmentioning

confidence: 65%

Section: Cutaneous Diseases Which Affect the Oesophagusmentioning

confidence: 76%

Section: B U L L O U S P E M P H I G O I Dmentioning

confidence: 99%

“…Treatment is with systemic steroids initially with or without additional topical steroids 107,108 . Most patients respond well to steroid therapy 107,108,110,111 …”

Section: Cutaneous Diseases Which Affect the Oesophagusmentioning

confidence: 99%

Section: Cutaneous Diseases Which Affect the Oesophagusmentioning

confidence: 99%

See 3 more Smart Citations

Novel and rare forms of oesophagitis

Malone

Sheahan

2020

Histopathology

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Eosinophilic esophagitis—established facts and new horizons

2021

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Despite dramatic advances in our understanding of the pathogenesis and course of disease in the relatively short timeframe since the discovery and first description of eosinophilic esophagitis (EoE) less than three decades ago, many open questions remain to be elucidated. For instance, we will need to better characterize atypical clinical presentations of EoE and other forms of esophageal inflammatory conditions with often similar clinical presentations, nut fulfilling current diagnostic criteria for EoE and to determine their significance and interrelationship with genuine EoE. In addition, the interrelationship of EoE with other immune-mediated diseases remains to be clarified. Hopefully, a closer look at the role of environmental factors and their interaction with genetic susceptibility often in context of atopic predisposition may enable identifying the candidate substances/agents/allergens and potentially earlier (childhood) events to trigger the condition. It appears plausible to assume that in the end—comparable to current concepts in other immune-mediated chronic diseases, such as for instance inflammatory bowel disease or asthma bronchiale—we will not be rewarded with the identification of a “one-and-only” underlying pathogenetic trigger factor, with causal responsibility for the disease in each and every EoE patient. Rather, the relative contribution and importance of intrinsic susceptibility, i.e., patient-driven factors (genetics, aberrant immune response) and external trigger factors, such as food (or aero-) allergens as well as early childhood events (e.g., infection and exposure to antibiotics and other drugs) may substantially differ among given individuals with EoE. Accordingly, selection and treatment duration of medical therapy, success rates and extent of required restriction in dietary treatment, and the need for mechanical treatment to address strictures and stenosis require an individualized approach, tailored to each patient. With the advances of emerging treatment options, the importance of such an individualized and patient-centered assessment will increase even further.

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Esophageal involvement in Bullous pemphigoid: Case report

Zahraoui,

Benjelloun,

Salihoun

et al. 2024

SAGE Open Medical Case Reports

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Bullous pemphigoid is a rare chronic autoimmune dermatologic blistering disease that usually affects elderly patients. Mucosal lesions are present in about 10%–35% of cases and affects most frequently the mucous membranes of the eye or the mouth. Esophageal involvement is possible but is rare (4% of cases). It could be asymptomatic, or presents with dysphagia, odynophagia, chest pain, or upper gastro-intestinal bleeding. We report the case of a recently diagnosed bullous pemphigoid in a 73-years-old female with normochromic normocytic anemia due to vitamin B12 deficiency who was referred to our unity for esophagogastroduodenoscopy. Our endoscopic examination revealed two bullae filled with blood at upper esophagus with linear ulcerations and membrane detachment upon withdrawal of the endoscope. Although bullous pemphigoid is mainly a skin disease, invasion of esophagus needs to be considered especially when symptoms are present or when no cause was found for blood loss or anemia.

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Esophageal Nikolsky’s Sign: A Rare Finding in a Patient with Bullous Pemphigoid

Cited by 5 publications

References 15 publications

Novel and rare forms of oesophagitis

Novel and rare forms of oesophagitis

Eosinophilic esophagitis—established facts and new horizons

Esophageal involvement in Bullous pemphigoid: Case report

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