Biopsy location for direct immunofluorescence in patients with suspected bullous pemphigoid impacts probability of a positive test result.

Background: Bullous pemphigoid (BP) is an autoimmune polymorphic skin disease characterized by erythematous papules and plaques and tense bullae. A skin biopsy for direct immunofluorescence (DIF) is used to detect autoantibodies and complement proteins.

Objective: We sought to determine which location would provide the highest probability of obtaining a positive DIF result.

Bullous pemphigoid associated with acquired hemophilia a: a rare association of autoimmune disease.

Background: Acquired hemophilia (AH) is a rare autoimmune disease with an annual incidence of one per million and has a mortality rate of up to 22%. It is caused by the development of autoantibodies against factor VIII. Approximately half of the reported cases are associated with autoimmune disorders, pregnancy, malignancies, and adverse drug reactions.