Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review
Bullous pemphigoid (BP) is a rare autoimmune disease, primarily affecting elderly individuals, that significantly impacts the patient’s quality of life. In contrast, psoriasis vulgaris (PV) is a common, chronic, immune-mediated skin condition recognized as a systemic T-cell-mediated disorder. We aim...
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2025-05-01
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| author | Maria-Alexandra Timofte Constantin Căruntu Beatrice Bălăceanu-Gurău Irina Mărgăritescu Călin Giurcăneanu Mara Mădălina Mihai |
| author_facet | Maria-Alexandra Timofte Constantin Căruntu Beatrice Bălăceanu-Gurău Irina Mărgăritescu Călin Giurcăneanu Mara Mădălina Mihai |
| author_sort | Maria-Alexandra Timofte |
| collection | DOAJ |
| description | Bullous pemphigoid (BP) is a rare autoimmune disease, primarily affecting elderly individuals, that significantly impacts the patient’s quality of life. In contrast, psoriasis vulgaris (PV) is a common, chronic, immune-mediated skin condition recognized as a systemic T-cell-mediated disorder. We aim to present the case of a patient suffering from a dermatologic association of BP and PV, which unveiled hepatitis C viral infection as a potential trigger and led to complex therapeutic challenges. A literature review is also included, exploring previous cases of overlapping BP and PV, along with a discussion of the unique pathogenic mechanisms and an analysis of the available therapeutic options. The patient, a 53-year-old male with a seven-year history of PV, presented with tense bullae overlying the psoriatic papules and plaques, with a generalized distribution. The presence of hepatitis C infection was considered a potential trigger for the concurrent presentation of BP and PV. Recent GWASs have demonstrated a potential causal relationship between PV and the subsequent development of BP, suggesting shared genetic susceptibility and immune pathways. However, the exact mechanisms driving this transition remain incompletely understood. Our case is particularly relevant as it exemplifies how environmental triggers—such as chronic hepatitis C infection—together with chronic cutaneous inflammation may act as cofactors in this process, possibly through the ‘epitope spreading’ phenomenon. This case underlines the importance of identifying triggering factors in patients with overlapping autoimmune diseases and reinforces the need for future research to further elucidate the pathogenic link between genotype and phenotype, in order to improve personalized therapeutic strategies. |
| format | Article |
| id | doaj-art-a80c7d23b17a4c6cadef3b966fa93bba |
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| issn | 2039-7283 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Clinics and Practice |
| spelling | doaj-art-a80c7d23b17a4c6cadef3b966fa93bba2025-08-20T02:33:31ZengMDPI AGClinics and Practice2039-72832025-05-011559110.3390/clinpract15050091Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature ReviewMaria-Alexandra Timofte0Constantin Căruntu1Beatrice Bălăceanu-Gurău2Irina Mărgăritescu3Călin Giurcăneanu4Mara Mădălina Mihai5Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Pathology, Onco Team Diagnostic, 030138 Bucharest, RomaniaDepartment of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaBullous pemphigoid (BP) is a rare autoimmune disease, primarily affecting elderly individuals, that significantly impacts the patient’s quality of life. In contrast, psoriasis vulgaris (PV) is a common, chronic, immune-mediated skin condition recognized as a systemic T-cell-mediated disorder. We aim to present the case of a patient suffering from a dermatologic association of BP and PV, which unveiled hepatitis C viral infection as a potential trigger and led to complex therapeutic challenges. A literature review is also included, exploring previous cases of overlapping BP and PV, along with a discussion of the unique pathogenic mechanisms and an analysis of the available therapeutic options. The patient, a 53-year-old male with a seven-year history of PV, presented with tense bullae overlying the psoriatic papules and plaques, with a generalized distribution. The presence of hepatitis C infection was considered a potential trigger for the concurrent presentation of BP and PV. Recent GWASs have demonstrated a potential causal relationship between PV and the subsequent development of BP, suggesting shared genetic susceptibility and immune pathways. However, the exact mechanisms driving this transition remain incompletely understood. Our case is particularly relevant as it exemplifies how environmental triggers—such as chronic hepatitis C infection—together with chronic cutaneous inflammation may act as cofactors in this process, possibly through the ‘epitope spreading’ phenomenon. This case underlines the importance of identifying triggering factors in patients with overlapping autoimmune diseases and reinforces the need for future research to further elucidate the pathogenic link between genotype and phenotype, in order to improve personalized therapeutic strategies.https://www.mdpi.com/2039-7283/15/5/91bullous pemphigoidpsoriasis vulgarishepatitis C virusepitope spreadinggenome-wide association studiesgenotype–phenotype correlation |
| spellingShingle | Maria-Alexandra Timofte Constantin Căruntu Beatrice Bălăceanu-Gurău Irina Mărgăritescu Călin Giurcăneanu Mara Mădălina Mihai Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review Clinics and Practice bullous pemphigoid psoriasis vulgaris hepatitis C virus epitope spreading genome-wide association studies genotype–phenotype correlation |
| title | Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review |
| title_full | Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review |
| title_fullStr | Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review |
| title_full_unstemmed | Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review |
| title_short | Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review |
| title_sort | bullous pemphigoid overlapping psoriasis vulgaris a rare case report and literature review |
| topic | bullous pemphigoid psoriasis vulgaris hepatitis C virus epitope spreading genome-wide association studies genotype–phenotype correlation |
| url | https://www.mdpi.com/2039-7283/15/5/91 |
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