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Keiji Sugiura, Mariko Sugiura, Chika Kondo and Tetsuhiko Sato
A 69-year-old male with CRF due to DM developed PV. This patient suddenly developed bullas and erosions on his arms and thighs which spread to his trunk, neck, limbs, hands and feet after a 4-year history of PV. Our diagnosis was PV coexisting with BP from the results of a skin biopsy and the results of anti-BP 180 and 230 antibodies detection. We started the systemic administration of steroid tablets, but we did not elect immunosuppressive therapies (cyclosporine and methotrexate) because of his hypertension and the risk of malignancy. The treatment of the patient’s DM was modified from oral medicine to insulin injections. After three weeks of treatment, his laboratory results showed the eosinophilia (41.3%), and we increased the dose of steroids (betamethazone 2 mg/day) and anti-histamine tablets. After the 1.5 months of his hospitalization, his cutaneous condition and eosinophilia improved. There could be as many as 100 cases of PV coexisting with BP, and this is a rare case of PV complicated with BP and eosinophilia.