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Wang S, Sun J, Deng S, Wu L, Li W, Ye T, Wu F, Wu Y, Zhou H. Lichen planus pemphigoides induced by anti-PD-1 antibody: A case only involved in oral mucosa with excellent topical treatment efficiency. J Cutan Pathol 2024; 51:114-118. [PMID: 37846754 DOI: 10.1111/cup.14547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/18/2023] [Accepted: 10/02/2023] [Indexed: 10/18/2023]
Abstract
Lichen planus pemphigoides (LPP) is a rare autoimmune subepidermal disease that can occur in patients receiving immune checkpoint inhibitors. Its clinical manifestations are combined with the characteristics of lichen planus with bullous pemphigoid that can occur on either skin or oral mucosa. It should be noted that oral LPP is very rare. Here, we report a novel case of oral LPP induced by an anti-PD-1 agent. The patient presented with typical clinical features in oral mucosa, and the diagnosis was based on histopathology and immunological studies. Given that the patient was receiving an anti-PD-1 agent, topical therapy was chosen, and a nice therapeutic effect was obtained. No significant recurrence was observed after a 2-year follow-up. A good and stable therapeutic effect achieved by rapid and local symptomatic medication suggests that accurate and sensitive diagnosis is necessary.
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Affiliation(s)
- Shimeng Wang
- Department of Oral Medicine, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jun Sun
- Department of Oral Medicine, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Oral Medicine, Stomatological Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Shuzhi Deng
- Department of Oral Medicine, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lanyan Wu
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wei Li
- Department of Dermatology & Rare Disease Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tingpei Ye
- Department of Oral Medicine, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Fanglong Wu
- Department of Oral Medicine, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yang Wu
- Department of Oral Medicine, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of General Dentistry, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hongmei Zhou
- Department of Oral Medicine, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Hashimoto T, Qian H, Ishii N, Nakama T, Tateishi C, Tsuruta D, Li X. Classification and Antigen Molecules of Autoimmune Bullous Diseases. Biomolecules 2023; 13:703. [PMID: 37189450 PMCID: PMC10135556 DOI: 10.3390/biom13040703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023] Open
Abstract
Autoimmune bullous diseases (AIBDs), which are a group of tissue-specific autoimmune diseases of the skin, present with various blistering lesions on the skin and mucous membranes, and show autoantibodies of IgG, IgA and IgM against epidermal cell surfaces and basement membrane zone. To date, AIBDs have been classified into a number of distinct subtypes by clinical and histopathological findings, and immunological characteristics. In addition, various biochemical and molecular biological studies have identified various novel autoantigens in AIBDs, which has resulted in proposals of new subtypes of AIBDs. In this article, we summarized various distinct AIBDs, and proposed the latest and most comprehensive classification of AIBDs with their autoantigen molecules.
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Affiliation(s)
- Takashi Hashimoto
- Department of Dermatology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Hua Qian
- Department of Laboratory Medicine, Medical College, Dalian University, Dalian 116622, China
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Takekuni Nakama
- Department of Dermatology, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Chiharu Tateishi
- Department of Dermatology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Xiaoguang Li
- Department of Laboratory Medicine, Medical College, Dalian University, Dalian 116622, China
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Lahouel M, Aounallah A, Mokni S, Sriha B, Belajouza C, Denguezli M. Severe childhood lichen planus pemphigoides after hepatitis A vaccination. SKIN HEALTH AND DISEASE 2022; 2:e94. [PMID: 35677923 PMCID: PMC9168010 DOI: 10.1002/ski2.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- M. Lahouel
- Department of Dermatology Farhat Hached Hospital of Sousse Sousse Tunisia
| | - A. Aounallah
- Department of Dermatology Farhat Hached Hospital of Sousse Sousse Tunisia
| | - S. Mokni
- Department of Dermatology Farhat Hached Hospital of Sousse Sousse Tunisia
| | - B. Sriha
- Department of Pathology Farhat Hached Hospital of Sousse Sousse Tunisia
| | - C. Belajouza
- Department of Dermatology Farhat Hached Hospital of Sousse Sousse Tunisia
| | - M. Denguezli
- Department of Dermatology Farhat Hached Hospital of Sousse Sousse Tunisia
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Papara C, Danescu S, Sitaru C, Baican A. Challenges and pitfalls between lichen planus pemphigoides and bullous lichen planus. Australas J Dermatol 2022; 63:165-171. [PMID: 35196400 DOI: 10.1111/ajd.13808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/06/2022] [Accepted: 01/28/2022] [Indexed: 12/20/2022]
Abstract
Lichen planus pemphigoides (LPP) and bullous lichen planus (BLP) are rare dermatoses, which are characterised by blisters and lichenoid lesions. Their clinical presentation is heterogenous, displaying overlapping features or mimicking other dermatological diseases. Therefore, diagnosis can often be challenging, requiring a thorough dermatological examination along with distinctive histological and immunopathological characteristics. Lichenoid degeneration of the basal epidermis exposes various antigens of the dermal-epidermal junction in LPP, resulting in the breakdown of immune tolerance, hence, the production of autoantibodies against type XVII collagen. Conversely, no pathogenic autoantibodies are detected in BLP. However, some cases of mucosal lichen planus might display immunopathological features suggestive of autoimmune blistering diseases. Therefore, a better understanding of the pathophysiology of these two distinct dermatoses is imperative. The aim of this review was to provide a summary of the current knowledge on the clinical hallmarks, diagnosis and available therapeutic options in LPP and BLP.
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Affiliation(s)
- Cristian Papara
- Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sorina Danescu
- Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cassian Sitaru
- Centre for Biological Signaling Studies (BIOSS), University of Freiburg, Freiburg, Germany
| | - Adrian Baican
- Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Ioannides D, Vakirlis E, Kemeny L, Marinovic B, Massone C, Murphy R, Nast A, Ronnevig J, Ruzicka T, Cooper S, Trüeb R, Pujol Vallverdú R, Wolf R, Neumann M. European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol 2020; 34:1403-1414. [DOI: 10.1111/jdv.16464] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/31/2020] [Indexed: 12/15/2022]
Affiliation(s)
- D. Ioannides
- Department of Dermatology and Venereology Aristotle University of Thessaloniki Medical School Thessaloniki Greece
| | - E. Vakirlis
- Department of Dermatology and Venereology Aristotle University of Thessaloniki Medical School Thessaloniki Greece
| | - L. Kemeny
- Department of Dermatology and Allergology University of Szeged Szeged Hungary
| | - B. Marinovic
- Department of Dermatology and Venereology University Hospital Center and School of Medicine Zagreb Zagreb Croatia
| | - C. Massone
- Department of Dermatology Medical University of Graz Graz Austria
| | - R. Murphy
- Department of Dermatology Nottingham University Hospital Nottingham UK
| | - A. Nast
- Department of Dermatology, Venereology and Allergy Division of Evidence‐Based Medicine Charité ‐ Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | | | - T. Ruzicka
- Department of Dermatology and Allergology LMU Munich Germany
| | - S.M. Cooper
- Department of Dermatology Oxford University Hospitals NHS Trust and University of Oxford Oxford UK
| | - R.M. Trüeb
- Center for Dermatology and Hair Diseases Wallisellen Switzerland
| | | | - R. Wolf
- Department of Dermatology and Allergology LMU Munich Germany
| | - M. Neumann
- Department of Dermatology Erasmus MC Rotterdam The Netherlands
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Pizzatti L, Ferreli C, Conti B, Atzori L, Pinna G, Pilloni L, Rongioletti F. Childhood erythrodermic lichen planus pemphigoides after nonavalent human papillomavirus vaccination. JAAD Case Rep 2020; 6:431-433. [PMID: 32382638 PMCID: PMC7200189 DOI: 10.1016/j.jdcr.2020.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Laura Pizzatti
- Section of Dermatology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Section of Dermatology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Brunella Conti
- Section of Dermatology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Atzori
- Section of Dermatology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Giampietro Pinna
- Section of Pathology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Luca Pilloni
- Section of Pathology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Franco Rongioletti
- Section of Dermatology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
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Hübner F, Langan EA, Recke A. Lichen Planus Pemphigoides: From Lichenoid Inflammation to Autoantibody-Mediated Blistering. Front Immunol 2019; 10:1389. [PMID: 31312198 PMCID: PMC6614382 DOI: 10.3389/fimmu.2019.01389] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/03/2019] [Indexed: 12/17/2022] Open
Abstract
Lichen planus pemphigoides (LPP) is a very rare autoimmune sub-epidermal blistering disease associated with lichenoid skin changes. Initially thought to be a mere variant of more common inflammatory dermatoses, particularly Bullous Pemphigoid (BP) or Lichen Planus (LP), a growing body of evidence suggests that it is a disease entity in its own right. In common with a range of autoimmune blistering diseases, including BP, pemphigoid gestationis (PG), mucous membrane pemphigoid (MMP) and linear IgA dermatosis (LAD), a key feature of the disease is the development of autoantibodies against type XVII collagen (COL17). However, accurately establishing the diagnosis is dependent on a careful correlation between the clinical, histological and immunological features of the disease. Therefore, we present an up to date summary of the epidemiology and etiopathogenesis of LPP, before illustrating the predisposing and precipitating factors implicated in the development of the disease. In addition to a selective literature search, we compare reports of potential drug-induced cases of LPP with pharmacovigilance data available via OpenVigil. We subsequently outline the cardinal clinical features, important differential diagnoses and current treatment options. We conclude by demonstrating that an improved understanding of LPP may not only lead to the development of novel treatment strategies for the disease itself, but may also shed new light on the pathophysiology of more common and treatment-refractory autoimmune blistering diseases.
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Affiliation(s)
- Franziska Hübner
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Ewan A. Langan
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Dermatological Sciences, University of Manchester, Manchester, United Kingdom
| | - Andreas Recke
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Lübeck Institute of Dermatological Research, University of Lübeck, Lübeck, Germany
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Sun S, Zhong B, Li W, Jin X, Yao Y, Wang J, Liu J, Dan H, Chen Q, Zeng X. Immunological methods for the diagnosis of oral mucosal diseases. Br J Dermatol 2019; 181:23-36. [PMID: 30585301 DOI: 10.1111/bjd.17589] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 02/05/2023]
Abstract
Immunological methods, which have been widely used in autoimmune blistering diseases (AIBDs) of the oral mucosa, can also be adopted as auxiliary diagnostic tools in oral lichen planus (OLP) and discoid lupus erythematosus (DLE). AIBDs, characterized by autoantibodies against structural proteins of keratinocytes or the basement membrane zone, clinically present as blisters and erosions of the oral mucosa. When atypical lesions occur, OLP or DLE may be confused with AIBDs. The improvement of diagnostic accuracy is necessary due to the significant differences in treatment and prognosis among these diseases. A variety of immunological methods are used for qualitative and quantitative detection of target antigens and autoantibodies. These methods can evaluate efficacy of treatment, monitor diseases and guide treatment decisions. In this review, we discuss the application of immunofluorescence, biochemical tests, and protein microarrays for AIBDs, OLP and DLE, as well as the differential diagnostic methods using immunological tests.
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Affiliation(s)
- S Sun
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - B Zhong
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - W Li
- Department of Dermatovenereology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, China
| | - X Jin
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences and College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Y Yao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Zunyi Medical University, Zunyi, China
| | - J Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - J Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - H Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Q Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - X Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
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