Hemorrhagic vesiculobullous eruption on the palms and the soles as presentation of dyshidrosiform bullous pemphigoid

Dyshidrosiform bullous pemphigoid (DP) is an unusual localized variant of bullous pemphigoid (BP), first described by Levine et al1 in 1979. It presents with a persistent and recurrent vesicobullous eruption, sometimes hemorrhagic, localized to the soles and/or palms. Since the clinical manifestations of DP are similar to those of pompholyx or bullous tinea pedis, which are more common and benign dermatologic diseases, a proper diagnosis could be delayed. We report the case of an 82-year-old man affected by DP who was treated for months for pompholyx and bullous tinea pedis with dermatophytid reaction.