Childhood erythrodermic lichen planus pemphigoides after nonavalent human papillomavirus vaccination

Case report: Successful treatment of non-bullous lichen planus pemphigoides with dupilumab

Lichen planus pemphigoides (LPP) is a rare autoimmune bullous disease, characterized by the coexistence of lichen planus and subepidermal bullae. However, the minority of LPP patients present with papules rather than vesicles or blisters, which is defined as non-bullous LPP. The diagnosis of LPP relies on manifestations, histopathology, serological assay, and direct immunofluorescence of linear disposition of IgG and/or C3 at the basement membrane zone. Up to now, no standard therapeutic strategies have been proposed for the treatment of LPP. Herein, we describe an uncommon non-bullous LPP patient with widespread papules and erythema, probably induced by vaccination. During hospitalization, he had a poor response to the conventional treatment of topical and systemic corticosteroids, and his condition was finally alleviated by the addition of dupilumab. For LPP patients with a traditional medication failure, or who were not suitable for a higher dose of corticosteroids, a combination with dupilumab could be an alternative option.

Severe childhood lichen planus pemphigoides after hepatitis A vaccination

Background

Lichen planus (LP) pemphigoides (LPP) is a very rare autoimmune bullous disorder, that is, exceptional in children.

Case Report

We report a case of LP pemphigoides with severe cutaneous and mucosal involvement in an 8‐year‐old girl who consulted for multiple vesicular and bullous lesions associated with shiny erythematous‐purple plaques. The eruption occurred 2 months after vaccination against hepatitis A virus. The diagnosis of LP pemphigoides was confirmed by histopathology and immunofluorescence examination. The patient received oral corticosteroid therapy with rapid improvement.

Conclusion

To our knowledge, this is the first report of LPP following hepatitis A vaccination, among adults and children.