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Epitope Spreading Phenomenon: A Case Report.
Keerthana Krishnaswamy1, Belliappa Pemmada Raju1, Leena Raveendra1
1Department of Dermatology, Rajarajeshwari Medical College and Hospital, Bengaluru, Karnataka, India.
Indian Dermatology Online Journal
|September 24, 2019
Summary
Psoriasis vulgaris and bullous pemphigoid rarely occur together. A patient with psoriasis experienced bullous pemphigoid, and a combination therapy proved effective.
Area of Science:
- Dermatology
- Autoimmune blistering diseases
- Psoriasis vulgaris
Background:
- Psoriasis vulgaris (PV) is a chronic inflammatory skin condition.
- Bullous pemphigoid (BP) is an autoimmune blistering disease.
- Concomitant PV and BP is exceptionally rare.
Observation:
- A 55-year-old male with a four-year history of PV presented with widespread fluid-filled lesions.
- The patient had a history of irregular topical treatment for PV.
- The new lesions were indicative of bullous pemphigoid.
Findings:
- A combination treatment regimen was initiated.
- The regimen included prednisolone, cyclosporine, and dapsone.
- Methotrexate was later added, proving suitable and effective.
Implications:
- This case highlights the rare co-occurrence of PV and BP.
- Effective management strategies for this rare comorbidity are crucial.
- Further research into the pathogenesis and treatment of concurrent PV and BP is warranted.
