Bullous pemphigoid during ustekinumab therapy in a psoriatic patient

Onsun, Nahide; Sallahoglu, Kadriye; Dizman, Didem; Özlem, Su; Tosuner, Zeynep

doi:10.1684/ejd.2016.2888

Cited by 27 publications

(18 citation statements)

References 10 publications

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“…The use of ustekinumab in psoriasis is associated with an excellent safety profile. However, isolated reports exist of immune-mediated adverse events in patients treated with this drug: cases of small vessel vasculitis, 8 bullous pemphigoid,9, 10, 11 and linear IgA bullous dermatosis 12 have been described. These cases indicate that antibody-antigen complex disease (vasculitis) and loss of B-cell tolerance with autoantibody-mediated disease (immune-bullous disease) may occur in patients undergoing IL-12 and IL-23 inhibition (Table I).…”

Section: Discussionmentioning

confidence: 99%

New-onset autoantibody-mediated nephritis during ustekinumab therapy for psoriasis in patients with and without prior systemic lupus erythematosus

2019

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Section: Discussionmentioning

confidence: 99%

New-onset autoantibody-mediated nephritis during ustekinumab therapy for psoriasis in patients with and without prior systemic lupus erythematosus

2019

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“…Aldesleukin (recombinant IL2) has been suspected as a causative agent for DABP (Table SII 1 ) Patients with BP have been demonstrated to have ele vated levels of IL23 and IL17 contained in the lesional skin and serum (78). Reports describe ustekinumab, an IL12/23 antagonist with downstream suppression of the Th1 and IL-17 inflammatory pathway, as achieving control of BP in patients with coexisting psoriasis (79), while paradoxically demonstrated to have been asso ciated with causing the condition in others (80). These findings suggest that immunological state may be altered from Th1 to Th2 dominance with the ensuing release of Th2associated chemokines (eotaxin and monocyte chemoattractant protein4) known in the pathogenesis of BP (81).…”

Section: Drugs Implicated In Drug-associated Bullous Pemphigoidmentioning

confidence: 99%

A Systematic Review of Drug-Induced Pemphigoid

Verheyden

Temel²,

Murrell³

2020

Acta Derm Venereol

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SIGNIFICANCE • Our article provides a comprehensive review of the medications implicated in drug-associated bullous pemphigoid with detailed accounts of the associated pathomechanisms. • Having read this article, clinicians will be capable of suspecting and diagnosing drug-associated bullous pemphigoid, enabling prompt management to be implemented. Bullous pemphigoid is an autoimmune subepithelial disease characterised by pruritus followed by urticarial plaques and finally bullae on the skin and mucosa. Drug-associated bullous pemphigoid (DABP) is a term used to describe instances of bullous pemphigoid demonstrating clinical, histological, or immunopathological features identical or similar to those of the idiopathic form of bullous pemphigoid, associated with the systemic ingestion, or topical application of particular drugs. In this study, we conducted a comprehensive search of the literature according to PRISMA guidelines and a total of 170 publications were included in the final qualitative analysis. In conclusion, 89 drugs were implicated in DABP. The strongest evidence for DABP is seen with gliptins, PD-1/PD-L1 inhibitors, loop diuretics, penicillin and derivatives. An appreciation of the medications associated with bullous pemphigoid enables clinicians to identify potential cases of DABP earlier and cease the offending medication.

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“…After reviewing the literature, we found 22 cases of anti‐inflammatory BA‐induced AIBD, which are summarized in Table . We identified three additional cases suspicious for the development of AIBD following treatment with such agents as secukinumab, infliximab, and golimumab, which were ultimately excluded due to lack of diagnostic criteria to diagnose a specific AIBD.…”

Section: Resultsmentioning

confidence: 99%

Autoimmune blistering diseases provoked during the treatment of chronic inflammatory disease with biologic agents: a systematic review

Gibson

Amber

2019

Int J Dermatology

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Background To investigate the clinical course of autoimmune blistering diseases (AIBDs) following treatment with biologic agents (BAs) for chronic inflammatory diseases.Methods A comprehensive review of available, published literature was performed using PubMed and CINAHL search engines. Diagnostic criteria of AIBD included positive direct immunofluorescence studies and/or positive serology with clinically suggestive features.Results A total of 22 cases of AIBDs provoked by the use of BAs were found. The most commonly implicated agents were tumor necrosis factor-alpha inhibitors (n = 14). The mean age of onset of AIBD was 59.4 years (median 61.5 years, range 31-82). Average time to onset of AIBD following initiation of the suspected BA was 33.7 AE 43.8 weeks (range 3 days to 152 weeks). Psoriasis was the most common associated condition for which the BA was prescribed (n = 11), followed by rheumatoid arthritis (n = 6) and ulcerative colitis (n = 5). Of the 21 cases reporting AIBD outcome, 17 reported remission or complete resolution upon stopping treatment with the involved BA. Four cases reported continued bullae formation without worsening of disease following cessation of the BA or systemic corticosteroids used to treat the AIBD. Five cases rechallenged the patient with the involved BA and four of the five reported recurrence, often with quicker onset and more severe symptoms.Conclusions BAs may be suspected in patients developing AIBD while being treated for chronic inflammatory diseases. A majority of cases resolve upon cessation of the offending agent.

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Bullous pemphigoid during ustekinumab therapy in a psoriatic patient

Cited by 27 publications

References 10 publications

New-onset autoantibody-mediated nephritis during ustekinumab therapy for psoriasis in patients with and without prior systemic lupus erythematosus

New-onset autoantibody-mediated nephritis during ustekinumab therapy for psoriasis in patients with and without prior systemic lupus erythematosus

A Systematic Review of Drug-Induced Pemphigoid

Autoimmune blistering diseases provoked during the treatment of chronic inflammatory disease with biologic agents: a systematic review

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