A 76-year-old man with a history of stage 3 melanoma treated with nivolumab presented with a persistent eruption of intensely pruritic papules on the trunk that started six months after initiating immunotherapy. He denied skin blistering. The patient also reported recurrent blood-filled blisters in the mouth that ruptured to form painful erosions. Physical examination revealed scattered erythematous papules without vesiculation on the back (Figure 1A), excoriated papules on the chest (Figure 1B), and several shallow erosions of the buccal mucosa (Figure 1C). Immunohistochemical (IHC) staining of the skin biopsy showed linear deposition of complement protein C3d along the dermal-epidermal junction (Figure 2) and enzyme-linked immunosorbent assay (ELISA) revealed anti-BP180 antibodies, confirming a diagnosis of bullous pemphigoid
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