Frontiers in medicine · 2022
Case report: A rare case of imiquimod-induced atypical pemphigus vulgaris.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Moro Francesco, Ciccone Davide, Fania Luca, Mariotti Feliciana, Salemme Adele, Rahimi Siavash, Pallotta Sabatino, Di Zenzo Giovanni
Аннотация
BACKGROUND: Pemphigus 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 PRESENTATION: We 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.
CONCLUSION: Topical Imiquimod therapy might induce atypical pemphigus vulgaris in some patients.
CASE PRESENTATION: We 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.
CONCLUSION: Topical Imiquimod therapy might induce atypical pemphigus vulgaris in some patients.