Bullous pemphigoid with localized umbilical involvement.

© 2009 The Authors. doi: 10.2340/00015555-0644 Journal Compilation © 2009 Acta Dermato-Venereologica. ISSN 0001-5555 Sir, Bullous pemphigoid (BP) is the most frequent autoimmune bullous disorder. BP is associated with anti bodies to two hemidesmosomal proteins, BP180 (type XVII collagen) and BP230 (1). The disorder usually affects elderly people, and severe pruritus is typically present. In the majority of patients, lesions are generalized and are most common on flexural aspects of the limbs and lower abdomen (2). By contrast, localized forms have also been reported at particular sites, including the pretibial area, palmo-plantar region, and genital, perineal, and perianal area, or confined to sites previously affected by, for example, radiotherapy, surgery, trauma, and burns, as well as around stomata and haemodialysis fistulae (2–4). Localized lesions may remain localized or develop into classical BP.