Bullous pemphigoid is an autoimmune disease characterized by subepidermal bullae that can involve nearly any skin surface and primarily affects the elderly. Only in a minority of cases are there known precipitating factors, some of which include vaccinations.1
Report of a Case. An 86-year-old white man with a 5-year history of bullous pemphigoid presented with a flare of disease activity. Until this flare, his disease had been well controlled for approximately 1 year, and he was blister free under treatment with mycophenolate mofetil, 500 mg/d, prednisone, 5 mg/d, and doxycycline, 100 mg/d. He was recently diagnosed as having bladder cancer and began intravesical bacillus Calmette-Guérin (BCG) treatments. New blister development began approximately 1 week after initiating therapy. By the end of the second week, he was experiencing a significant flare and declined further BCG treatment. His prednisone dose was increased to 20 mg/d, and his symptoms rapidly improved by his clinic visit.