Generalized pustular psoriasis complicated with bullous pemphigoid

Tsuchida, Yukihiro; Ansai, Osamu; Nakajima, Mami; Oginezawa, Mahoko; Kawai, Tōru; Yokoyama, Rei; Deguchi, Tokiko; Hama, Natsumi; Shinkuma, Satoru; Abe, Riichiro

doi:10.1111/ijd.14332

Cited by 1 publication

(3 citation statements)

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“…8 However, there are a few documented cases of simultaneous development or coexistence of GPP and pemphigoid. [3][4][5][6] Clinical and immunological features of comorbid pemphigoid in patients with psoriasis have not been extensively investigated.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a retrospective study of 122 patients with psoriasis vulgaris and 13 with GPP with coexisting AIBD reported that bullous pemphigoid and laminin γ1 pemphigoid were the two most frequent coexisting AIBDs 8 . However, there are a few documented cases of simultaneous development or coexistence of GPP and pemphigoid 3–6 …”

Section: Discussionmentioning

confidence: 99%

“…Although patients with psoriasis vulgaris are known to have a higher incidence of AIBD than the general population, particularly for pemphigoid, 1,2 there are only a few concise reports on the coexistence of GPP and AIBD. [3][4][5][6] Here, we describe a case of simultaneous development of GPP and pemphigoid with multiple autoantibodies in a patient with a history of immune checkpoint inhibitor (ICI) treatment for lung cancer.…”

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confidence: 99%

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Simultaneous development of generalized pustular psoriasis and pemphigoid with multiple autoantibodies in a complete responder of pembrolizumab for lung cancer

Kochi,

Miyachi,

Tagashira

et al. 2023

The Journal of Dermatology

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Patients with psoriasis vulgaris have a higher incidence of pemphigoid than the general population. However, there are only a few concise reports on the coexistence of generalized pustular psoriasis (GPP) and pemphigoid. The authors describe a rare case of the simultaneous development of GPP and pemphigoid with multiple autoantibodies (i.e., BP180–C‐terminal, 200‐kDa protein, and laminin 332 proteins) in a complete responder of immune checkpoint inhibitor (ICI) treatment for lung cancer. Anti–interleukin 17 inhibitors for the GPP and oral corticosteroids at 10 mg/day for the pemphigoid effectively achieved remission in both diseases. It may not be uncommon to detect multiple autoantibodies in patients with pemphigoid; however, the detection of autoantibodies to more than three antigens in a single patient is relatively rare. In the current patient, the severe inflammation of GPP might have generated multiple autoantibodies. In addition, although pembrolizumab achieved a complete response and was discontinued 9 months before the onset of GPP and pemphigoid, the ICI might have affected the development of the two diseases. This case report adds useful information to the limited knowledge regarding the coexistence of GPP and pemphigoid, and aids in a better understanding of the pathological mechanisms and treatment options for such patients. Furthermore, the possibility that more patients may develop multiple autoimmune and autoinflammatory diseases in the era of ICIs should be recognized.

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