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Acute erythematous rash on the trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Bullous pemphigoid can on occasions be induced by: ClonidineFurosemideDiclofenacIbuprofen
Blistering skin disorders
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
It is a distinct bullous skin disorder characterized by autoantibodies against p200 protein at the dermoepidermal junction. Clinically, the disease resembles pemphigoid with tense cutaneous blisters. Diagnosis can be made only by detecting antibodies against p200 by Western blot against an extract of the upper dermis.
Skin diseases of the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
Cicatrizing pemphigoid (Figure 15) is a subepithelial blistering disorder involving skin and mucous membranes and results in scarring in these areas. The lesions involve the oral conjunctiva and the nasopharyngeal, laryngeal, esophageal, genital and rectal mucosa. Skin lesions occur in one third of cases and favor the scalp, face and upper trunk. They appear as tense bullae and erosions. The disease tends to be chronic and progressive. On direct immunofluorescence there are immunoreactants (mainly IgG and C3 but also IgA and IgM) in the epithelial basement membranes. A localized form of this disease, the so-called Brunsting-Perry pemphigoid, is characterized by recurrent localized subepidermal blistering and scarring of the head and neck.
Granzyme B as a therapeutic target: an update in 2022
Published in Expert Opinion on Therapeutic Targets, 2022
Alexandre Aubert, Michael Lane, Karen Jung, David J. Granville
Pemphigoid diseases (PD) are a group of seven autoimmune disorders characterized by subepithelial blistering in response to autoantibody production against structural components of the dermal-epidermal junction (DEJ) [57]. The DEJ is a multiprotein complex that comprises architectural hemidesmosomal proteins of the BM (Laminins and ColIV), ColVII anchoring fibrils, as well as cell surface receptors (ColXVII and α6β4 integrins). Altogether, hemidesmosomes attach the intracellular cytoskeleton of basal keratinocytes to the lamina lucida and lamina densa of the BM, thus delineating the stratum basale of the epidermis and maintaining homeostasis. Hemidesmosomes also contribute to skin integrity by linking the epidermis/BM complex to the underlying dermal connective tissue (Figure 2, left panel) [58,59].
Safety and tolerability of linagliptin in Asians with type 2 diabetes: a pooled analysis of 4457 patients from 21 randomized, double-blind, placebo-controlled clinical trials
Published in Expert Opinion on Drug Safety, 2022
Keizo Kanasaki, Shen Qu, Fumiko Yamamoto, Cornelia Schepers, Rafael Sani Simões, Daisuke Yabe, Linong Ji
In 2015, a safety signal for bullous pemphigoid with DPP-4 inhibitors was identified from a disproportionality analysis of the US Food and Drug Administration Adverse Event Reporting System. Consequently, US prescribing information for DPP-4 inhibitors was updated to include bullous pemphigoid, an autoimmune skin disorder characterized by blisters. Japanese prescribing information was updated similarly in 2016 following a request from the Pharmaceuticals and Medical Devices Agency. In our analysis, we did not detect any cases of bullous pemphigoid or other types of skin lesions. However, bullous pemphigoid occurs mainly in patients over the age of 70, whereas patients in our analysis were younger on average (mean of 55 years). Notably, no cases of bullous pemphigoid were detected in Asian participants in the CARMELINA trial where the average age was higher (65 years), despite a numerical imbalance in the overall trial cohort with seven cases in the linagliptin group (0.2%) and none in the placebo group [10]. There were no cases of pemphigoid with linagliptin monotherapy in 2235 patients in a three-year post-marketing surveillance study in Japan [62], while a similar three-year post-marketing surveillance study in Japan observed two cases in 3372 patients (0.06%) receiving linagliptin added to other glucose-lowering drugs [63].
Relapse of bullous pemphigoid: an update on this stubborn clinical problem
Published in Annals of Medicine, 2018
Yiman Wang, Xuming Mao, Yanhong Wang, Yueping Zeng, Yidi Liu, Hongzhong Jin, Li Li
Relapse has always been a major problem in management of bullous pemphigoid. Although factors including but not limited to ageing, disease severity, neurological disorder, ECP, BAFF, IL-17, IL-23 and CXCL10 levels have been shown to be related to relapse, confirmation studies are needed before using them for guidance for relapse prevention. Identification of the borderline value of BP180 antibody to predict relapse is a remarking breakthrough in finding a preventative method for relapse of BP. Meanwhile, given the difficulties in identifying patients at risk of relapse and the potentially serious consequences, there is a strong desire for further studies to quantitatively define the borderline values of risk factors. Particularly, potential indicative factors like inflammatory cells and cytokines should be quantified for finding patients at risk of relapse precisely and managing them properly. Being aware of the potential risks, we propose to select optimal treatment options with low-dose CS adherence for relapse prevention. Current evidence has demonstrated that longer usage of CS with a low dose, combination of immunosuppressants and IVIG are helpful in lowering relapse rate. Lastly, multi-centre, large-sample-size studies and consistency of inclusion and exclusion criteria among different articles are lacked in most of current studies on relapse of BP, which requires us to come up with better research method such as large-scale cooperative studies or meta-analysis to explore BP’s relapse.