Bullous pemphigoid-like rash revealing hypereosinophilic syndrome

Abstract

Hypereosinophilic syndrome (HES) is a rare haematologic disorder characterised by unexplained, persistent eosinophilia with organ involvement. We report the case of a 74-year-old patient who presented with a pemphigoid-like bullous rash as the only manifestation of an HES. This report highlights the importance of the dermatological manifestations of this potentially life-threating condition that may initially present as a skin-limited disease. Bullous pemphigoid (BP) is a very common autoimmune blistering dermatosis that may share common clinical and histological features or associate with an HES. HES should be considered when patients diagnosed with BP demonstrate atypical course under corticosteroids and/or recalcitrant blood eosinophilia.

Recalcitrant course of Bullous pemphigoid indicating the coexistence with Hypereosinophilic syndrome. A case report and literature review.

“…BP is a very common blistering disorder that can be associated with HES (9). HES must be considered especially in patients with atypical response to corticosteroids with blood eosinophilia (9). Our patient presented first with limited bullous lesions that resolved with corticosteroid treatment, but later recurred with a more generalized aggressive course with no response for low dose of corticosteroids.…”

“…When the genetic test is positive the best treatment is imatinib, whereas when the test is negative corticosteroids is considered as a first line of treatment (8). This case report shows the important role of dermatologists in diagnosing every skin manifestation even when cutaneous lesions are limited because it can highlight a life-threatening condition (9). BP is a very common blistering disorder that can be associated with HES (9).…”

“…This case report shows the important role of dermatologists in diagnosing every skin manifestation even when cutaneous lesions are limited because it can highlight a life-threatening condition (9). BP is a very common blistering disorder that can be associated with HES (9). HES must be considered especially in patients with atypical response to corticosteroids with blood eosinophilia (9).…”

Recalcitrant course of bullous pemphigoid indicating coexisting hypereosinophilic syndrome: A case report and literature review

“…8 This case report underscores the critical role of dermatologists in diagnosing every skin manifestation, even when cutaneous lesions are limited, because a lifethreatening condition may exist. 9 BP is a common blistering disorder that may be associated with HES. 9 HES must be considered in patients with atypical corticosteroids response and eosinophilia.…”

Acute Liver Failure Due to Hypereosinophilic Syndrome Accompanied by Duodenal Perforation

“…Gastrointestinal and hepatic involvement were simultaneously observed, similar to the present case. Khallaayoune et al reported a patient with HES who presented with bullous pemphigoid-like rash ( 12 ). In our case, although the patient had a history of bullous pemphigoid, the skin rash that appeared at the time of the diagnosis of HES was considered to be different from bullous pemphigoid, based on the findings of the skin biopsy.…”