Coexisting bullous pemphigoid and psoriasis successfully treated with etanercept

Cusano, Francesco; Iannazzone, Silvia S.; Riccio, G.; Piccirillo, Fabio

doi:10.1684/ejd.2010.0970

Cited by 18 publications

(12 citation statements)

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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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“…74,75 There have been a few reports of successful use of TNFα inhibitors in MMP. [76][77][78][79][80][81][82] Etanercept can be effective in controlling severe MMP cases in patients who fail conventional immunosuppressive agents, but controlled trials are absent. Etanercept can be considered as an off-label alternative treatment for patients with MMP who would require aggressive immunosuppressive regimens.…”

Section: Systemic Medicationsmentioning

confidence: 99%

Mucous membrane pemphigoid

2020

Definitions

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Autoantibodies to one or several autoantigens in the mucosal or epithelial BMZ have been identified in MMP patients. 4-10 The association of MMP with human leukocyte antigen (HLA) major histocompatibility class II HLA-DQB1*0301 has been demonstrated. 11-13 The cause is usually unknown, but there are a few reports of MMP triggered by medications such as methyldopa, clonidine and D-penicillamine. 14, 15 EPIDEMIOLOGY The true incidence of MMP is unclear. A recent study from the United Kingdom demonstrated that ocular MMP accounted for 61% of the cases of newly diagnosed cicatricial conjunctivitis and the incidence was calculated as 0.8 per million population. 16 The incidence of MMP was estimated to be 1.3-2.0 per million per year in France and Germany. 17, 18 MMP predominantly affects women more often than men with a male to female ratio of nearly 2:1. 19 MMP mainly occurs in the elderly population, commonly observed between 60 and 80 years of age. 20 Albeit rare, children may also be affected. Approximately 20 cases of childhood onset MMP have been reported, among whom the youngest one was 10 months old. 21-23 There is no known racial or geographic predilection.

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“…8 In addition, three cases of coexisting psoriasis vulgaris and BP were treated successfully with etanercept. [9][10][11] Some patients with mucous membrane pemphigoid have also shown good responses to etanercept. 12 Taken together, etanercept may be an effective treatment option for BP.…”

Section: Case Of Coexisting Psoriatic Arthritis and Bullous Pemphigoimentioning

confidence: 99%