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{
    "pk": 1415,
    "title": "Bullous Pemphigoid Causing Successive Emergency Department Visits",
    "subtitle": null,
    "abstract": "<p><b>Case Presentation:</b> In this case presentation, an 84-year-old male with Fitzpatrick type IV skin tone experienced blistering due to bullous pemphigoid (BP), first on the distal upper left extremity and then on the distal lower extremities, chest, and back. These symptoms resulted in three visits to the emergency department within a month, as well as an episode of hospitalization. Despite treatment, the blistering did not resolve until future outpatient care with dermatology.</p><p><br></p><b>Discussion:</b> Bullous pemphigoid is a rare autoimmune disease where autoantibodies target hemidesmosomal proteins causing basement membrane destruction and tense subepithelial bullae with pruritus. While uncommon, the incidence of BP is increasing. Bullous pemphigoid tends to affect older adults, appearing as a rash prior to bullae formation on the abdomen, extremities, groin, axillae, or mucosa. Bullous pemphigoid may also be drug-related with atypical symptoms. Diagnosis of BP should be based on immunopathology, and initial treatment of BP is through corticosteroid or doxycycline.<br>",
    "language": "eng",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Bullous pemphigoid"
        },
        {
            "word": "Bullae"
        },
        {
            "word": "Blister"
        },
        {
            "word": "Pruritus"
        }
    ],
    "section": "Images in Emergency Medicine",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5g51j4wt",
    "frozenauthors": [
        {
            "first_name": "Edmund",
            "middle_name": "",
            "last_name": "Hsu",
            "name_suffix": "",
            "institution": "University of California Irvine, Department of Emergency Medicine, Orange, California",
            "department": ""
        },
        {
            "first_name": "Andrew",
            "middle_name": "T.",
            "last_name": "Kinoshita",
            "name_suffix": "",
            "institution": "University of California Irvine, School of Medicine, Orange, California",
            "department": ""
        },
        {
            "first_name": "C.",
            "middle_name": "Eric",
            "last_name": "McCoy",
            "name_suffix": "",
            "institution": "University of California Irvine, Department of Emergency Medicine, Orange, California",
            "department": ""
        }
    ],
    "date_submitted": "2023-05-31T04:24:04.661000Z",
    "date_accepted": "2023-07-28T09:29:53.854000Z",
    "date_published": "2023-10-27T13:00:00Z",
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        "label": "Final Article",
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        "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1415/galley/2701/download/"
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            "label": "Final Article",
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}