[Brain and blisters: a special bond].

Abstract

Bullous pemphigoid (BP) is a dermatological autoimmune disease characterized by itch and blisters. Sometimes the blisters are preceded by years of itching and eczematous patches, which can cause a delay in recognition of BP. The disease is caused by production of autoantibodies against the hemidesmosomal proteins BP180 and BP230 at the dermal-epidermal junction. An association between BP and neurodegenerative disorders, such as Parkinson's disease, is known. However, this association is not commonly known amongst health care professionals, but is of clinical significance. Neurodegenerative disorders (including Parkinson's disease) are thought to disrupt the blood brain barrier, resulting in exposure of neuronally located BP180 and BP230 to the immune system. In most studies that have examined the association between BP and Parkinson's disease (and other neurodegenerative disease), BP develops several years after the diagnosis of Parkinson's. We present a case of a patient with proven bullous pemphigoid who developed clinical features of Parkinson's disease during follow-up at the dermatology outpatient clinic. After neurological analysis, the patient most likely suffered from long-standing Parkinson's disease.