Dermatitis herpetiformis evolving into bullous pemphigoid: a probable example of ‘epitope spreading’

Abstract
We report a case of dermatitis herpetiformis which, 11 years after its original diagnosis, evolved into bullous pemphigoid. Only a few similar cases supported by immunfluorescence studies have been reported previously, and we believe that they represent examples of ‘epitope spreading’, an increasingly recognized phenomenon used to explain the coexistence of autoimmune diseases.