Concomitant Psoriasis and Bullous Pemphigoid – a Case Report / Udružena pojava psorijaze i buloznog pemfigoida – prikaz slučaja

Abstract

Concomitant occurrence of psoriasis and bullous pemphigoid was described in less than 100 cases in the literature. The co-occurrence affects the treatment approach of patients. We present a case of a 58-year-old man with psoriasis presenting with erythematous plaques, tense bullae, erosions and fever up to 39°C. Direct and indirect immunofluorescence and histopathological examination confirmed the diagnosis of bullous pemphigoid. In our case, bullous eruptions were successfully treated with oral methylprednisolone and dapsone, and psoriasis with narrowband ultraviolet B phototherapy and acitretin. In conclusion, the etiopathogenesis of the coexistence of these two entities remains unknown, but it may be related to relatively high incidence of psoriasis and bullous pemphigoid, respectively. Both conditions are immunologically mediated and combined immunosuppressive regimens, directed at cellular and humoral immune responses, usually result in clinical improvement.