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2026, Vol: 16, Issue: 2
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Case Report
Online Published: 12 Aug 2026
 


Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab

Ummul Khair, Nayeem Sadath Haneef.


Abstract
Bullous pemphigoid (BP) is an autoimmune blistering disorder characterized by pruritic tense bullae, predominantly affecting the elderly. Several clinical variants have been described. Here, we report a rare ecthyma-gangrenosum-like atypical presentation of bullous pemphigoid in a young epileptic patient. A 33-year-old male farmer presented with multiple pruritic and painful erosions covered with thick adherent necrotic crust over the feet, legs, and upper limbs, sparing other body areas and mucosae, for 15 days. He reported a history of multiple tense blisters over the trunk three months earlier that had resolved with systemic corticosteroids. The patient had been receiving antiepileptic medications for eight years for generalized tonic-clonic seizures. Diagnosis of bullous pemphigoid was confirmed by characteristic complement C3c deposits at the basement membrane zone on direct immunofluorescence (DIF) of perilesional skin and subepidermal cleavage on histopathology from the earlier episode. There was no significant improvement with systemic corticosteroids, antibiotics, and supportive therapy. He was subsequently treated with rituximab, resulting in marked improvement within one month. This case of ecthyma-gangrenosum-like bullous pemphigoid is reported as it was a hitherto rarely described morphological variant occurring in a young patient with neurological association and for its excellent response to rituximab when conventional treatment was unsatisfactory.

Key words: Atypical variant, Bullous pemphigoid, Ecthyma-gangrenosum-like, Neurological association, Rituximab


 
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How to Cite this Article
Pubmed Style

Khair U, Haneef NS. Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab. J Med Allied Sci. 2026; 16(2): 122-125. doi:10.5455/jmas.316779

Web Style

Khair U, Haneef NS. Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab. https://jmas.in/?mno=316779 [Access: August 12, 2026]. doi:10.5455/jmas.316779

AMA (American Medical Association) Style

Khair U, Haneef NS. Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab. J Med Allied Sci. 2026; 16(2): 122-125. doi:10.5455/jmas.316779


Vancouver/ICMJE Style

Khair U, Haneef NS. Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab. J Med Allied Sci. (2026), [cited August 12, 2026]; 16(2): 122-125. doi:10.5455/jmas.316779


Harvard Style

Khair, U. & Haneef, . N. S. (2026) Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab. J Med Allied Sci, 16 (2), 122-125. doi:10.5455/jmas.316779


Turabian Style

Khair, Ummul, and Nayeem Sadath Haneef. 2026. Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab. Journal of Medical and Allied Sciences, 16 (2), 122-125. doi:10.5455/jmas.316779


Chicago Style

Khair, Ummul, and Nayeem Sadath Haneef. "Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab." Journal of Medical and Allied Sciences 16 (2026), 122-125. doi:10.5455/jmas.316779


MLA (The Modern Language Association) Style

Khair, Ummul, and Nayeem Sadath Haneef. "Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab." Journal of Medical and Allied Sciences 16.2 (2026), 122-125. Print. doi:10.5455/jmas.316779


APA (American Psychological Association) Style

Khair, U. & Haneef, . N. S. (2026) Ecthyma-gangrenosum-like rare atypical presentation of bullous pemphigoid in a young patient with neurological disorder treated with rituximab. Journal of Medical and Allied Sciences, 16 (2), 122-125. doi:10.5455/jmas.316779


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