Case of lichen planus pemphigoides after pembrolizumab therapy for advanced urothelial carcinoma

Okada, Hirofumi; Murata, Satoru; Sugihara, Toru; Sato, Atsuko; Maekawa, Takeo; Komine, Mayumi; Ohtsuki, Mamitaro

doi:10.1111/1346-8138.15461

Cited by 11 publications

(10 citation statements)

References 4 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 Recently, a few cases of LPP induced by pembrolizumab have been reported (Table S1). [2][3][4][5] Antibodies against BP180NC16a were detected in all previous cases, while antibodies against the C-terminal region of BP180 were detected in our case. There were no clinical differences between the above two types, but our patient had a good response to a small dose of oral steroid (PSL 10 mg/day).…”

Section: Dear Editorsupporting

confidence: 42%

Lichen planus pemphigoides with antibodies against the BP180 C‐terminal domain induced by pembrolizumab in a melanoma patient

Yoshida

Shiraishi

Yatsuzuka

et al. 2021

The Journal of Dermatology

View full text Add to dashboard Cite

Section: Dear Editorsupporting

confidence: 42%

Lichen planus pemphigoides with antibodies against the BP180 C‐terminal domain induced by pembrolizumab in a melanoma patient

Yoshida

Shiraishi

Yatsuzuka

et al. 2021

The Journal of Dermatology

View full text Add to dashboard Cite

“…Although lichenoid dermatitis and bullous pemphigoid related to anti-PD1 therapy are relatively common; as of June 2020, there were only 7 reported cases of LPP identified in PubMed and Ovid databases. [27][28][29][30][31][32][33] Patient demographics and clinical characteristics are summarized in Table 1. Five patients had lung cancer, 27,28,32,33 2 had urothelial cancer, 30 and the other patients had melanoma, 29 hepatocellular carcinoma, or merkel cell carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Lichen Planus Pemphigoides Associated With PD-1 and PD-L1 Inhibitors: A Case Series and Review of the Literature

Boyle

Ashi

Puiu

et al. 2022

The American Journal of Dermatopathology

View full text Add to dashboard Cite

Immune checkpoint inhibitors are increasingly being used in the treatment of various solid organ and hematologic malignancies. Dermatologic toxicities associated with programmed cell death protein-1 (PD-1) and programmed death ligand-1 (PD-L1) therapy have been widely reported in the literature. It is important for clinicians to be aware of these toxicities to ensure prompt recognition and treatment. Herein, we present the clinical, histopathologic, and immunofluorescence findings of 3 patients diagnosed with lichen planus pemphigoides (LPP) after treatment with anti-PD-1 inhibitors. We also reviewed the literature and summarize 7 previously reported cases of LPP associated with anti-PD-1 and anti-PD-L1 inhibitors. LPP was diagnosed at a median time of 24.4 weeks (range: 4-78 weeks) after initiation of immunotherapy. Clinical findings included papules, plaques, erosions, vesicles, and bullae on the trunk and extremities. Oral involvement was present in half the cases. Histopathologic features of immunotherapy-induced LPP included lichenoid or vacuolar interface dermatitis, the presence of eosinophils, and subepidermal bullae. Direct immunofluorescence demonstrated linear deposition of immunoglobulin G (IgG) or C3. Indirect immunofluorescence demonstrated linear IgG along basement membrane zone on monkey esophagus in 2 cases and linear IgG on the epidermal side of salt split skin in 3 cases. Serum anti-BP180 was elevated in all cases in which enzyme-linked immunosorbent assay was performed.

show abstract

“…Serological BP180 antibody is consistently positive in all 14 reported cases of PD-1/PD-L1 inhibitor–induced LPPemph. 10–16 There are 3 plausible explanations to account for the absence of detectable BP180 antibodies in this case. First, negative ELISA studies may be due to the prior and ongoing steroid therapy at the time of serology testing, resulting in fluctuating titers with subsiding disease severity leading to systematically undetectable levels of circulating antibodies.…”

Section: Discussionmentioning

confidence: 92%

“…8,9 To the best of our knowledge, the subepidermal bullae in these cases has only been reported at the nonfollicular dermal-epidermal junction. [10][11][12][13][14][15][16][17][18][19] Furthermore, positive serological tests for BP180 and/or BP230 antibodies have been reported in all tested cases. [10][11][12][13][14][15][16] In this report, we present a case of a follicular immunobullous dermatosis with a negative serological test of BP180 and BP230 antibodies in a nivolumab-treated patient and further discuss the possible underlying pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

Lichen Planopilaris Pemphigoides: A Novel Bullous Dermatosis Due to Programmed Cell Death Protein-1 Inhibitor Therapy

Liu

Howard

Fattah

et al. 2023

The American Journal of Dermatopathology

View full text Add to dashboard Cite

Lichen planus pemphigoides (LPPemph), apart from bullous pemphigoid, is a rare bullous dermatosis that can be induced by programmed cell death protein-1 (PD-1)/PD ligand 1 (PD-L1) inhibitors. The primary location of PD-1/PD-L1 inhibitor-induced LPPemph has previously only been reported at the nonfollicular dermal-epidermal junction. We present a case of nivolumab-induced LPPemph with an intense perifollicular lichenoid reaction, prominent multifocal perifollicular clefting, which in addition, was also accompanied by linear IgG and C3 immunofluorescence deposits along the dermal-epidermal junction as well as demonstrating a perifollicular pattern. Intriguingly, the serological study of BP180 and BP230 antibodies was negative, suggesting the presence of additional novel antibodies, which primarily favor hair follicles and may contribute to the pathogenesis. Therefore, we consider this entity a novel variant of PD-1/PD-L1 inhibitor-induced bullous dermatosis. To the best of our knowledge, this is the first report that highlights perifollicular bullae accompanied by immunofluorescence findings in a PD-1/PD-L1 inhibitor-induced lesion. We propose a new immunotherapy associated entity, lichen planopilaris pemphigoides, and emphasize the significance of perifollicular changes in the pathogenesis.

show abstract

Case of lichen planus pemphigoides after pembrolizumab therapy for advanced urothelial carcinoma

Cited by 11 publications

References 4 publications

Lichen planus pemphigoides with antibodies against the BP180 C‐terminal domain induced by pembrolizumab in a melanoma patient

Lichen planus pemphigoides with antibodies against the BP180 C‐terminal domain induced by pembrolizumab in a melanoma patient

Lichen Planus Pemphigoides Associated With PD-1 and PD-L1 Inhibitors: A Case Series and Review of the Literature

Lichen Planopilaris Pemphigoides: A Novel Bullous Dermatosis Due to Programmed Cell Death Protein-1 Inhibitor Therapy

Contact Info

Product

Resources

About