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

Autor:	Foerster Y; Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.; Deutsches Zentrum Immuntherapie, Erlangen, Germany., Sollfrank L; Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.; Deutsches Zentrum Immuntherapie, Erlangen, Germany., Rechtien L; Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.; Deutsches Zentrum Immuntherapie, Erlangen, Germany., Harrer T; Deutsches Zentrum Immuntherapie, Erlangen, Germany.; Infectious Diseases and Immunodeficiency Section, Department of Internal Medicine 3, Universitatsklinikum Erlangen, Erlangen, Germany., Berking C; Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.; Deutsches Zentrum Immuntherapie, Erlangen, Germany., Sticherling M; Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.; Deutsches Zentrum Immuntherapie, Erlangen, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in immunology [Front Immunol] 2023 May 24; Vol. 14, pp. 1179294. Date of Electronic Publication: 2023 May 24 (Print Publication: 2023).
DOI:	10.3389/fimmu.2023.1179294
Abstrakt:	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. Competing Interests: CB has received honoraria from Sanofi. MS has participated in clinical studies conducted by Sanofi and Regeneron. MS also participated in advisory boards by Sanofi. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest. (Copyright © 2023 Foerster, Sollfrank, Rechtien, Harrer, Berking and Sticherling.)
Databáze:	MEDLINE
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