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Case Report: A Rare Case of Pembrolizumab-Induced Bullous Pemphigoid

The programmed cell death protein 1 inhibitor pembrolizumab, an immune checkpoint inhibitor, has subsequently been approved for the treatment of a wide variety of malignant tumors. Compared with conventional chemotherapy, immunotherapy is associated with a unique set of immune reactions, known colle...

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Autores principales: Zhang, Xiaoyan, Sui, Dongjiang, Wang, Dong, Zhang, Lina, Wang, Ruiyan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477373/
https://www.ncbi.nlm.nih.gov/pubmed/34594337
http://dx.doi.org/10.3389/fimmu.2021.731774
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author Zhang, Xiaoyan
Sui, Dongjiang
Wang, Dong
Zhang, Lina
Wang, Ruiyan
author_facet Zhang, Xiaoyan
Sui, Dongjiang
Wang, Dong
Zhang, Lina
Wang, Ruiyan
author_sort Zhang, Xiaoyan
collection PubMed
description The programmed cell death protein 1 inhibitor pembrolizumab, an immune checkpoint inhibitor, has subsequently been approved for the treatment of a wide variety of malignant tumors. Compared with conventional chemotherapy, immunotherapy is associated with a unique set of immune reactions, known collectively as immune-related adverse events. Although often mild, dermatologic toxicity can occasionally be high grade and potentially life-threatening. Here we describe a rare case of bullous pemphigoid (BP) associated with pembrolizumab. A 79-year-old male patient presented with scattered erythema, papules, blisters, and pruritus after pembrolizumab treatment. Then, the rash gradually aggravated and spread to the whole body. The extensive edematous erythema, blisters, bullae, and blood blisters were loose and easy to rupture, forming an erosive surface and with pruritus and obvious pain. The hemidesmosomal protein BP180 (type XVII collagen) was detectable in the serum, and the histological examination diagnosis was bullous pemphigoid. After 10 days of glucocorticoid (methylprednisolone, iv, 80 mg/day) treatment, new blister formation ceased. We need to increase the awareness on and facilitate the earlier identification of the cutaneous adverse effects of BP with immunotherapy so that treat can begin early in order to limit the duration and severity of toxicity.
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spelling pubmed-84773732021-09-29 Case Report: A Rare Case of Pembrolizumab-Induced Bullous Pemphigoid Zhang, Xiaoyan Sui, Dongjiang Wang, Dong Zhang, Lina Wang, Ruiyan Front Immunol Immunology The programmed cell death protein 1 inhibitor pembrolizumab, an immune checkpoint inhibitor, has subsequently been approved for the treatment of a wide variety of malignant tumors. Compared with conventional chemotherapy, immunotherapy is associated with a unique set of immune reactions, known collectively as immune-related adverse events. Although often mild, dermatologic toxicity can occasionally be high grade and potentially life-threatening. Here we describe a rare case of bullous pemphigoid (BP) associated with pembrolizumab. A 79-year-old male patient presented with scattered erythema, papules, blisters, and pruritus after pembrolizumab treatment. Then, the rash gradually aggravated and spread to the whole body. The extensive edematous erythema, blisters, bullae, and blood blisters were loose and easy to rupture, forming an erosive surface and with pruritus and obvious pain. The hemidesmosomal protein BP180 (type XVII collagen) was detectable in the serum, and the histological examination diagnosis was bullous pemphigoid. After 10 days of glucocorticoid (methylprednisolone, iv, 80 mg/day) treatment, new blister formation ceased. We need to increase the awareness on and facilitate the earlier identification of the cutaneous adverse effects of BP with immunotherapy so that treat can begin early in order to limit the duration and severity of toxicity. Frontiers Media S.A. 2021-09-14 /pmc/articles/PMC8477373/ /pubmed/34594337 http://dx.doi.org/10.3389/fimmu.2021.731774 Text en Copyright © 2021 Zhang, Sui, Wang, Zhang and Wang 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
Zhang, Xiaoyan
Sui, Dongjiang
Wang, Dong
Zhang, Lina
Wang, Ruiyan
Case Report: A Rare Case of Pembrolizumab-Induced Bullous Pemphigoid
title Case Report: A Rare Case of Pembrolizumab-Induced Bullous Pemphigoid
title_full Case Report: A Rare Case of Pembrolizumab-Induced Bullous Pemphigoid
title_fullStr Case Report: A Rare Case of Pembrolizumab-Induced Bullous Pemphigoid
title_full_unstemmed Case Report: A Rare Case of Pembrolizumab-Induced Bullous Pemphigoid
title_short Case Report: A Rare Case of Pembrolizumab-Induced Bullous Pemphigoid
title_sort case report: a rare case of pembrolizumab-induced bullous pemphigoid
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477373/
https://www.ncbi.nlm.nih.gov/pubmed/34594337
http://dx.doi.org/10.3389/fimmu.2021.731774
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