Bullous pemphigoid mistaken for a burn

Abstract

Burns in the elderly are extremely common. Often, the history is obscure or nonexistent because of confusion or dementia. We describe the case of a 78-year-old woman who was admitted to a burns center with the history of a 21% scald burn. However, this burn had unusual characteristics, and further investigation confirmed the cause to be bullous pemphigoid. This case report highlights the extreme care that must be taken in the assessment of children and the elderly who may not be able to give a complete history. We also present a table to aid in the differential diagnosis of unusual burns, which may be useful in such circumstances.