Case report: A rare case of imiquimod-induced atypical pemphigus vulgaris

Autor: Francesco Moro, Davide Ciccone, Luca Fania, Feliciana Mariotti, Adele Salemme, Siavash Rahimi, Sabatino Pallotta, Giovanni Di Zenzo
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Frontiers in Medicine, Vol 9 (2022)
Druh dokumentu: article
ISSN: 2296-858X
DOI: 10.3389/fmed.2022.1054544
Popis: BackgroundPemphigus vulgaris is an autoimmune intraepithelial bullous disease involving the skin and the mucous membranes. Imiquimod, a topical therapy for skin basal cell carcinoma, is an amine that induces the production of tumor necrosis factor alfa, interleukin-1 and other cytokines. Pemphigus induced by drugs has been frequently reported, mostly after systemic therapy.Case presentationWe present the case of a 50-year-old man who developed skin, intraoral, and genital mucosae lesions 3 days after a treatment with Imiquimod for multiple superficial basal cell carcinoma of the trunk. Direct and indirect immunofluorescence results were compatible with the diagnosis of pemphigus vulgaris. Enzyme-linked immunosorbent assay was negative for desmoglein 1 and 3, but interestingly, by immunoblotting on keratinocyte extracts a band of 170 kDa was obtained by IgG. The patient, after interrupting Imiquimod application, started a treatment with prednisolone and in 4 weeks showed a complete remission.ConclusionTopical Imiquimod therapy might induce atypical pemphigus vulgaris in some patients.
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