A 44-year-old woman with refractory follicular lymphoma underwent allogeneic stem cell transplantation (SCT) and achieved
complete remission. Grade III acute graft-versus-host disease (GVHD) developed on day 23, but no chronic GVHD occurred. The
patient developed severe erosion with bullous lesions in the oral cavity 18 months after SCT. At that time, the lymphoma remained
in complete remission, and she had no clinical or laboratory findings suggesting chronic GVHD. A biopsy of the oral mucosa
showed moderate lymphoplasmacytic infiltration and subepidermal bullae, and direct immunofluorescence staining demonstrated
linear deposition of C3 at the dermo-epidermal junction. An immunoblotting assay using human epidermal extracts confirmed
the presence in her serum of an antibody against the 230-kd bullous pemphigoid antigen 1 (BPAG1). A diagnosis of cicatricial
pemphigoid (CP) was made, and complete resolution of the CP was achieved with pred-nisolone therapy. The occurrence of autoimmune
blistering diseases is rare after allogeneic SCT.
Key words Autoimmune blistering disease - Cicatricial pemphigoid - Autoantibody - Allogeneic stem cell transplantation - Graft-versus-host disease