Figurate erythema in a patient with bullous pemphigoid and Toxocara infection

Abstract

Figurate erythema can appear in a wide spectrum of dermatological diseases. Rarely, it can present as an atypical manifestation of bullous pemphigoid. Among eosinophilic dermatoses, figurate erythema may appear in Wells syndrome, which has been occasionally reported in association with Toxocara infection. We present the case of an older female patient diagnosed with bullous pemphigoid, who presented with an unusual combination of blisters and figurate erythema outside the area of blister formation. In addition, high blood eosinophilia associated with lymph node and bone marrow eosinophilia was diagnosed and was causally related to Toxocara canis infection. The patient was treated with dapsone for bullous pemphigoid and with albendazole for toxocariosis, with complete regression of all skin lesions and blood eosinophilia. This paper discusses the possible etiopathogenesis of figurate erythema in our patient and summarizes previous clinical and histological findings in bullous pemphigoid and eosinophilic dermatoses presenting with figurate erythema lesions.