[Idiopathic hypereosinophilic syndrome and bullous pemphigoid]

We report the case of bullous pemphigoid associated with hypereosinophilic syndrome. This association has only been report only once in the literature.

A 58 year-old man was admitted for a surinfected, pruriginous and generalized bullous dermatosis. Physical examination revealed bronchial rales. The cutaneous histology showed a junctional and intradermic cleavage associated with massive dermal infiltration by eosinophils. The diagnosis of a pemphigoid was confirmed by immunology. In parallel, the idiopathic hypereosinophilic syndrome was evoked in view of persisting hypereosinophilia without detected aetiology and associated with pulmonary infiltration. The skin lesions disappeared under symptomatic treatment, but the patient was rehospitalized 4 months later for severe relapse of dermatosis associated with medullary infiltration by eosinophils. Oral corticosteroid therapy gave spectacular results on both skin and blood formula.

This association is rare, but seems to be related by the same immunological factors highlighting eosinophils. In addition, the presence of hypereosinophilic syndrome gives the pemphigoid some particular clinical, histological and evolutive characteristics.