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Case report: Bullous pemphigoid in HIV-1-positive patients: interplay or coincidence? A case series and review of the literature

Bullous pemphigoid (BP) is an autoimmune inflammatory skin disease, mostly affecting the elderly population. Therefore, patients often have multiple comorbidities, but there is inconsistent data regarding the relationship between HIV-1 infection and BP, which has been rarely reported in combination....

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Autores principales: Foerster, Yannick, Sollfrank, Lukas, Rechtien, Laura, Harrer, Thomas, Berking, Carola, Sticherling, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244715/
https://www.ncbi.nlm.nih.gov/pubmed/37292193
http://dx.doi.org/10.3389/fimmu.2023.1179294
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author Foerster, Yannick
Sollfrank, Lukas
Rechtien, Laura
Harrer, Thomas
Berking, Carola
Sticherling, Michael
author_facet Foerster, Yannick
Sollfrank, Lukas
Rechtien, Laura
Harrer, Thomas
Berking, Carola
Sticherling, Michael
author_sort Foerster, Yannick
collection PubMed
description Bullous pemphigoid (BP) is an autoimmune inflammatory skin disease, mostly affecting the elderly population. Therefore, patients often have multiple comorbidities, but there is inconsistent data regarding the relationship between HIV-1 infection and BP, which has been rarely reported in combination. Herein, we describe three patients who presented with BP and concomitant HIV-1 infection that was well controlled with modern combined antiretroviral therapy. All patients received topical and oral corticosteroids. Depending on the individual severity, further add-on therapeutics, such as azathioprine, dapsone, doxycycline and the interleukin 4/13 antibody dupilumab, were added to the therapy regimen. All patients recovered from pruritic skin lesions and blistering. The cases are further discussed in the context of the current study landscape. In conclusion, HIV-1 infection shifts the cytokine profile from T-helper type 1 (TH1) towards T-helper type 2 (TH2), resulting in the excessive secretion of distinct cytokines, such as interleukin 4 (IL-4) and interleukin 10 (IL-10). With IL-4 being a main driver in the pathogenesis of BP, HIV-1-positive patients may benefit greatly from targeting IL-4 with monoclonal antibodies.
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spelling pubmed-102447152023-06-08 Case report: Bullous pemphigoid in HIV-1-positive patients: interplay or coincidence? A case series and review of the literature Foerster, Yannick Sollfrank, Lukas Rechtien, Laura Harrer, Thomas Berking, Carola Sticherling, Michael Front Immunol Immunology Bullous pemphigoid (BP) is an autoimmune inflammatory skin disease, mostly affecting the elderly population. Therefore, patients often have multiple comorbidities, but there is inconsistent data regarding the relationship between HIV-1 infection and BP, which has been rarely reported in combination. Herein, we describe three patients who presented with BP and concomitant HIV-1 infection that was well controlled with modern combined antiretroviral therapy. All patients received topical and oral corticosteroids. Depending on the individual severity, further add-on therapeutics, such as azathioprine, dapsone, doxycycline and the interleukin 4/13 antibody dupilumab, were added to the therapy regimen. All patients recovered from pruritic skin lesions and blistering. The cases are further discussed in the context of the current study landscape. In conclusion, HIV-1 infection shifts the cytokine profile from T-helper type 1 (TH1) towards T-helper type 2 (TH2), resulting in the excessive secretion of distinct cytokines, such as interleukin 4 (IL-4) and interleukin 10 (IL-10). With IL-4 being a main driver in the pathogenesis of BP, HIV-1-positive patients may benefit greatly from targeting IL-4 with monoclonal antibodies. Frontiers Media S.A. 2023-05-24 /pmc/articles/PMC10244715/ /pubmed/37292193 http://dx.doi.org/10.3389/fimmu.2023.1179294 Text en Copyright © 2023 Foerster, Sollfrank, Rechtien, Harrer, Berking and Sticherling https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Foerster, Yannick
Sollfrank, Lukas
Rechtien, Laura
Harrer, Thomas
Berking, Carola
Sticherling, Michael
Case report: Bullous pemphigoid in HIV-1-positive patients: interplay or coincidence? A case series and review of the literature
title Case report: Bullous pemphigoid in HIV-1-positive patients: interplay or coincidence? A case series and review of the literature
title_full Case report: Bullous pemphigoid in HIV-1-positive patients: interplay or coincidence? A case series and review of the literature
title_fullStr Case report: Bullous pemphigoid in HIV-1-positive patients: interplay or coincidence? A case series and review of the literature
title_full_unstemmed Case report: Bullous pemphigoid in HIV-1-positive patients: interplay or coincidence? A case series and review of the literature
title_short Case report: Bullous pemphigoid in HIV-1-positive patients: interplay or coincidence? A case series and review of the literature
title_sort case report: bullous pemphigoid in hiv-1-positive patients: interplay or coincidence? a case series and review of the literature
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244715/
https://www.ncbi.nlm.nih.gov/pubmed/37292193
http://dx.doi.org/10.3389/fimmu.2023.1179294
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