Case of coexisting psoriatic arthritis and bullous pemphigoid improved by etanercept

Nin, Megumi; Tokunaga, Daisaku; Ishii, Norito; Komai, Ayako; Hashimoto, Takashi; Katoh, Norito

doi:10.1111/j.1346-8138.2012.01659.x

Cited by 17 publications

(12 citation statements)

References 10 publications

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“…21 In several case reports anti-TNFa agents were found to be successful in the treatment of mucous membrane pemphigoid [22][23][24] and bullous pemphigoid that developed in patients with psoriasis. [25][26][27][28] At the same time, a number of case reports implicate anti-TNFa agents such as etanercept, 29 adalimumab 30,31 and efalizumab 32,33 as inducing agents. This paradox is difficult to explain since, although it is understood that these drugs block TNFa, the full extent of their effects on the immune system is still under investigation.…”

Section: Tnfa Inhibitorsmentioning

confidence: 99%

Drug‐induced pemphigoid: a review of the literature

Stavropoulos

Soura

Antoniou

2014

Acad Dermatol Venereol

225

260

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Bullous pemphigoid is an acquired autoimmune disease that is characterized by subepidermal blistering and affects mainly the elderly. The pathogenesis of the condition has not yet been fully elucidated, but it is widely accepted that a strong correlation with various medications may exist. In reality, more than 50 different drugs have been associated with the appearance of bullous pemphigoid and as new therapies emerge, this number is very likely to increase. A number of pathogenetic mechanisms have been proposed in the past. It is true that a delicate immunological balance is disturbed in all patients with the disease. The variable effects that may be exhibited by the use of biological drugs could shed some light in this complex immunological behaviour. At the same time, drug-induced bullous pemphigoid is difficult to differentially diagnose from its idiopathic counterpart, as the clinical picture and histopathological findings in both conditions may only have subtle differences. Patients who present with bullous pemphigoid and receive multiple regimens should always be suspected of suffering from the drug-induced variant of the condition. This possibility must be considered, as after the withdrawal of the suspect medication most patients respond rapidly to treatment and do not experience relapses.

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Section: Tnfa Inhibitorsmentioning

confidence: 99%

Drug‐induced pemphigoid: a review of the literature

Stavropoulos

Soura

Antoniou

2014

Acad Dermatol Venereol

225

260

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“…Psoriasis is also comorbid with other autoimmune diseases, including Vogt–Koyanagi–Harada disease, monoclonal gammopathy, immunoglobulin G4‐related disease, myasthenia gravis and, most importantly, bullous pemphigoid (especially anti‐laminin‐γ1 pemphigoid) . Hepatitis C virus infection may be associated with late‐onset psoriasis .…”

mentioning

confidence: 99%

“…(especially anti-laminin-c1 pemphigoid). [23][24][25] Hepatitis C virus infection may be associated with late-onset psoriasis. 26,27 A positive association between alcohol consumption and psoriasis remains controversial.…”

mentioning

confidence: 99%

Psoriasis: Behind the scenes

Furue

Kadono

2016

The Journal of Dermatology

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Psoriasis is a chronic inflammatory skin disease characterized by a significant deterioration in the quality of life of affected individuals. Notably, psoriasis is significantly associated with cardiovascular and metabolic syndrome and other autoimmune disorders. Recent progress in biologic therapies has revealed the fundamental role of tumor necrosis factor-a, interleukin (IL)-23 and the IL-17A axis together with aberrant overproduction of epidermal IL-36c in the pathogenesis of psoriasis. This review provides an update on the clinical, pathological and therapeutic advancements involving psoriasis.

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“…Anti‐TNF‐α agents have been associated with the development of cutaneous immune‐related adverse effects such as new‐onset or worsening of psoriasis, vasculitis, lupus‐like syndrome, Stevens‐Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, sarcoidosis, and dermatomyositis, while rarely associated with BP, PV, or LABD. Paradoxically, anti‐TNF‐α agents have been reported to be efficacious in the treatment of AIBD, though this has only been supported by small cases, with a lack of response in larger studies …”

Section: Discussionmentioning

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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Case of coexisting psoriatic arthritis and bullous pemphigoid improved by etanercept

Cited by 17 publications

References 10 publications

Drug‐induced pemphigoid: a review of the literature

Drug‐induced pemphigoid: a review of the literature

Psoriasis: Behind the scenes

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

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