Bullous Pemphigoid Following Total Knee Arthroplasty

CASE: A 72-year-old woman with no dermatologic history developed tense blisters, erosions, and eczematous lesions over the right knee after cemented bicompartmental total knee arthroplasty. Lesions progressed with oral mucosal involvement. Two months postoperatively, admission to dermatology department led to a diagnosis of bullous pemphigoid, confirmed by direct immunofluorescence of a skin biopsy, and indirect immunofluorescence with ELISA from blood. Treatment with oral methotrexate and topical clobetasol halted blistering and achieved resolution within 4 weeks. CONCLUSION: This case highlights the importance of early recognition of surgery-induced BP to prevent delays and enable timely therapy.