[Bullous pemphigoid and Parkinson's disease: about a case]. / Pemphigoïde bulleuse et maladie de Parkinson: à propos d'un cas.

Bullous pemphigoid (BP) is an organ-specific autoimmune disease which can be associated with many pathologies including degenerative neurological diseases such as Parkinson's and Alzheimer's disease. Studies have suggested the possibility of cross-immune responses through "epitope spreading". Bullous dermatosis has been reported to be secondary to neurological disease, at intervals ranging from a few months to a maximum of a few years. Then is it an unusual association or a causation? It has been suggested that drug consumption, decubitus lesions, traumatic events as well as reduced immunity can be triggers for BP in patients with neurological disease. We report the case of a 93-year old patient with a 10-year history of advanced Parkinson's disease, hospitalized for the treatment of a common bullous pemphigoid confirmed by histology and immunohistochemistry. The patient was treated with oral corticosteroids. After a week of treatment, the patient died due to septic shock. Neurological disorders represent a real risk factor for BP. BP could be considered as a marker for neurological disorder. These associations are of broad interest, because they can play a role in the etiopathogenesis of BP and contribute to a complete understanding of the causes of these neurodegenerative diseases.

[Multiple and extensive skin necrosis revealing anti phospholipid antibody syndrome]. / Nécroses cutanées multiples et extensives révélant un syndrome des anticorps anti phospholipids.

Antiphospholipid antibody syndrome (APS) is an acquired thrombophilic state resulting from autoantibodies activity against phospholipides and/or their cofactors. It may be primary or associated with various diseases, including systemic lupus erythematosus (SLE), which represents a potential severity marker. We here report the case of a young girl with multiple cutaneous necrosis suffering from APS secondary to SLE. Skin lesions associated with APS are common, polymorphic, sometimes inaugural and may be the only clinical manifestation of the syndrome. However, skin necrosis are rare; their treatment is based on anticoagulation therapy and appropriate local care. Rigorous long term follow up associated with closer cooperation between the dermatologist and the internist is justified by unpredictable outcomes and poor prognosis.