A Case of Newly Developed Pemphigus Foliaceus and Possible Association with Alternative Bee-Venom Therapy

Abstract

Bee-venom is composed of a variety of peptides, enzymes, and biogenic amines, and is demonstrated to have both antiinflammatory and immune-stimulatory effects in human body. Pemphigus foliaceus (PF) is a variant of pemphigus, which is a rare autoimmune bullous disease presenting with erythematous scaly crusted plaques. Although the exact pathogenesis was not identified, there have been three case reports of autoimmune disorders associated with bee-venom. In this case, a 64-year-old female was diagnosed with PF, which was developed after alternative bee-venom acupuncture therapy. We assumed that the bee-venom caused the diseases through a temporal relationship and its known immunostimulatory action. Herein, we suggest that physicians recognize the possibility of bee-venom stimulating the immune system and triggering various autoimmune diseases including pemphigus.

Principales componentes bioactivos y propiedades terapéuticas del veneno de abeja (Apis mellifera L.). Revisión

“…Otro tipo de complicaciones reportadas, no tan comunes, son: trombocitopenia inmunitaria (68) , linfedema (69) , síndrome de Guillain -Barré (70) , neuropatía óptica (71) , infarto pontino y talámico (72) , lesiones renales agudas (73) , síndrome de Wolff-Parkinson-White (74) , síndrome de Kounis (75) , pénfigo foliáceo (76) , por mencionar algunas. Estas complicaciones se deben principalmente a la acción inmunoestimuladora, y a la presencia de múltiples alérgenos proteicos con actividad enzimática e inductores de la IgE presentes en el VAM (18) .…”

Pemphigus: trigger and predisposing factors

“…Alternative medicine could be also a trigger for pemphigus. Yoo and coworkers reported a case of PF developed after a bee-venom acupuncture treatment and supposed that immunological stimulation by bee venom could have induced PF ( 41 ) ( Table 1 ).…”