Unilateral bullous pemphigoid in a hemiplegic patient

Abstract

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.

Bullous pemphigoid and the associated co-morbidities: A prospective study at a tertiary-care center

“…The pathogenesis of BP remains not established with concrete evidence. Some studies have shown that BP has a correlation with co-morbid conditions such as neurological and psychiatric diseases, diabetes mellitus, and malignancies [2][3][4]. Recently, it has also been observed that the incidence of BP has raised, which could be attributed to factors such as an aging population, an increase in drug-induced cases, and the ameliorated diagnosis of the non-bullous forms [5].…”