Brunsting-Perry cicatricial pemphigoid is a rare form of localised cicatritial pemphigoid, commonly occurring on head and neck region. Interestingly, it usually does not involve the mucosal membranes as seen in typical cicatricial pemphigoid. Clinical differential is localised bullous pemphigoid, in which there is hardly any scarring in comparison to Brunsting Perry cicatritial pemphigoid.
Histology of Brunsting-Perry cicatricial pemphigoid
Microscopy reveals subepidermal blistering with various admixture of inflammatory cell infiltrate. Early lesions may show small papillary microabscesses
Brunsting-Perry cicatricial pemphigoid pathology
Images provided by Dr Duncan Lamont, Waikato Hospital
Special studies in Brunsting-Perry cicatricial pemphigoid
Immunofluorescence shows basement membrane zone IgG and/or C3.
Electron microscopy reveals the split in the sublamina densa with preserved basal lamina and anchoring fibrils on the roof of the blister.
Differential diagnosis of Brunsting-Perry cicatricial pemphigoid
Localised bullous pemphigoid