Bullous pemphigoid localized in a primarily hemiplegic distribution

BP: bullous pemphigoid BPAG: bullous pemphigoid antigen CVA: cerebrovascular accident INTRODUCTION Bullous pemphigoid (BP) is an autoimmune disease that results in the formation of tense bullae, usually affecting the elderly population. The pathogenesis involves deposition of IgG autoantibodies in basement membrane hemidesmosomes followed by complement activation and subsequent recruitment of inflammatory cells. Clinically, this activity results in the formation of tense subepidermal blisters and urticarial papules and plaques, most commonly affecting flexural areas, the abdomen, and thighs. During the last decade, several observational studies have reported associations between BP and several neurologic disorders, including dementia, Parkinson disease, bipolar disorder, epilepsy, multiple sclerosis, and stroke. We present a case of BP in a patient with a recent cerebrovascular accident (CVA), primarily involving the same side of the body affected by the stroke.