Bullous pemphigoid associated with psoriasis, breast cancer and Parkinson's disease

Bullous pemphigoid (BP) and psoriasis vulgaris represent two clinically well characterized, inflammatory, chronic skin diseases. A 62 years old female patient, from rural areas, was admitted for the presence of erythematous plaques covered by large tense blisters with clear fluid, located symmetrically on the anterior part of the upper limbs, the trunk, the neck and the lower limbs. Also the lesions were intense itching. Lesions occurred three days before presentation at the clinic. Medical history revealed psoriasis diagnosed 28 years ago, breast cancer treated with surgery, radio and chemotherapy three years ago and Parkinson's disease diagnosed 3 weeks prior to presentation to the dermatology clinic. Histopathology examination revealed: atrophic epidermis with subepidermal presence of a blister containing numerous eosinophils and neutrophils. In the papillary dermis neutrophils and eosinophils predominantly vascular. Bullous pemphigoid has multiple etiology. Bullous pemphigoid is an autoimmune subepidermal bullous dermatosis which may be associated with psoriasis. Medical literature and cases reported in dermatology journals claim that bullous pemphigoid is often associated with psoriasis, though the immunogenetical and immunopathologycal mecanismes are still not known. Our patient has three different diseases but their etiology and pathogenesis can interfere.