Brunsting-Perry Pemphigoid Confined to the Scalp: A Clinicopathologic Mimicker of Discoid Lupus and Central Centrifugal Cicatricial Alopecia (CCCA).

Brunsting-Perry pemphigoid (BPP) is a rare variant of cicatricial pemphigoid that is difficult to diagnose due to its overlapping clinical and histopathologic features with other causes of scarring alopecia. Due to the rarity of this condition, to date, less than 100 cases have been documented in the literature. We present a 76-year-old female with a four-month history of painful, scaly lesions on the scalp, whose differential diagnosis originally included discoid lupus erythematosus and central centrifugal cicatricial alopecia due to their ability to mimic BPP. The diagnostic overlap in this case highlights how autoimmune blistering diseases like BPP can mimic both inflammatory dermatoses and primary cicatricial alopecias, reinforcing the need for careful clinicopathologic correlation to avoid misdiagnosis and to better guide treatment.