Sir, Bullous pemphigoid (BP) is the most common autoimmune bullous dermatosis, mainly affecting the elderly. Its association with neurological diseases has been reported for several years in several studies, including with strokes. We report a new case of unilateral BP in a hemiplegic patient. A 78-year-old patient with a history of hypertensive and ischemic heart disease and ischemic stroke three years ago was admitted for pruriginous bullous dermatosis evolving for one month prior to admission. A general examination revealed right hemiplegia with facial involvement and aphasia. A dermatological examination found localized erosions on the paralyzed side of the body, without urticarial or bullous lesions. Nikolsky’s sign was absent and the rest of the clinical examination was without abnormality (Figs. 1a – 1c). A skin biopsy revealed a skin coating widely ulcerated on the surface without eosinophilic infiltrate. Indirect immunofluorescence was positive at 1260. The diagnosis of BP was retained and the patient was started on a strong local dermocorticoid with a good evolution and the disappearance of the lesions after two months.
Our work concerned a retrospective study. This was done on the basis of the records of patients attending dermatology and having undergone an (DIF) over a period of two years (2015-2016). Thus, we have selected 30 cases in dermatology and for which a DIF was performed. The final diagnosis were distributed as follows: 02 cases of bullous pemphigoid, 04 cases of pemphigus (01 cases of deep pemphigus, 03 cases of superficial pemphigus) and 02 cases of lupus Erythematosus. According to the literature, the positivity rate of IFD in DBAI is very high. This doesn’t correspond to the results of our study which were: 66% in the pemphigus and 30% in the LES. Except for the bullous pemphigoïde whose rate correspond to the literature with 40%. The IFD has succeeded in demonstrating that it possesses a high diagnostic value in cutaneaous inflammatory dermatosis. It confirms a diagnosis and retains another.
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