Kaposi's sarcoma (KS) is the commonest human immunodeficiency virus (HIV)-related malignancy with its characteristic cutaneous morphological appearance and histopathological features. However, it can be simulated by other co-morbid opportunistic infections and unrelated dermatological conditions. We describe such a case of acroangiodermatitis in an HIV co-infected man, based on exclusion of KS histologically and the absence of human herpesvirus 8, the causative agent of KS.
Background
Bullous pemphigoid (BP) is an autoimmune blistering dermatosis associated with a number of neurological conditions, including idiopathic Parkinson's disease (IPD). Only 1 case of BP in a patient with multiple system atrophy (MSA) has been reported.
Cases
We report 3 cases of men with probable MSA who developed bullous pemphigoid at a latency of 4–6 years from MSA symptom onset.
Conclusions
Skin α‐synuclein deposition in neurodegenerative conditions such as IPD and MSA may be a potential substrate for the exposure of BP‐related antigens. Alternatively, central neurodegeneration may expose antigens as a substrate for cross‐reactivity and BP pathogenesis. Our report suggests an association between BP and MSA, in addition to the previously documented association with IPD.
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