By Gary M. White, MD

Anti-p200 pemphigoid (APP), aka anti-laminin γ1 pemphigoid, is a rare autoimmune bullous dermatosis that closely resembles classic bullous pemphigoid, but has tense blisters with preference for the hands and feet.


Almost all patients experience bulla and pruritus. Bulla are almost always found on the hands, with variable involvement of the arms, feet, and trunk.


Treatment usually involves topical and systemic steroids initially. Azathioprine, dapsone, and doxycycline may also be given.


This article contains an excellent review on diagnosing APP and differentiating it from classic bullous pemphigoid, EBA, and mucous membrane pemphigoid. JAMA Derm 2016;152;897.


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