PMC10290455_01
Generalized infiltrative erythema and plaques, tense vesicles and blisters on the trunk and extremities (Red arrows mark some of the typical psoriatic lesions, and black arrows mark the lesions of BP). Blisters basically appear on psoriatic lesions (A). Erosions and crusts mainly observed on his back and legs (B and C).
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The Psoriasis Area and Severity Index (PASI) score was 8.9 and the Bullous Pemphigoid Disease Area Index (BPDAI) is 62 (Figure 1).
Histopathological and direct immunofluorescence examinations from vesicular lesion. Subepidermal blistering with a small infiltration of lymphocytes and eosinophils in the superficial dermis (A) (H&E, 100x). Linear IgG and C3 deposits at the basement membrane zone (B).
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Furthermore, a minor infiltration of lymphocytes and eosinophils was detected surrounding the superficial dermal vessels (Figure 2A). Direct immunofluorescence (IF) showed that immunoglobulin G (IgG) and C3 were linearly deposited at the basement membrane zone (BMZ) (Figure 2B).
After 16-day treatment, the lesions of both psoriasis and BP largely subsided. Erythema, plaques, and blisters on the trunk have basically resolved (A and B). Dark erythema, plaques, and a few crusts are present on the legs (C).
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The post-treatment PASI score was 2.2 (reached PASI 75) and the BPDAI score was 2 (96% improvement) (Figure 3).