Bullous pemphigoid induced by m‐<scp>TOR</scp> inhibitors in renal transplant recipients

Atzori, Laura; Conti, Brunella; Zucca, M

doi:10.1111/jdv.12662

Cited by 13 publications

(9 citation statements)

References 14 publications

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“…Mammalian target of rapamycin (mTOR) inhibitors (sirolimus, everolimus) has been implicated as a causative agent in two cases of BP in renal transplant recipients ( 88 ). BP has previously been described in renal transplant patients due to a graft-related cross reaction with the skin, or dysregulation of the immune system non-specifically inducing production of autoantibodies ( 42 , 89 ).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Drug-Induced Pemphigoid

Verheyden

Temel²,

Murrell³

2020

Acta Derm Venereol

102

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SIGNIFICANCE • Our article provides a comprehensive review of the medications implicated in drug-associated bullous pemphigoid with detailed accounts of the associated pathomechanisms. • Having read this article, clinicians will be capable of suspecting and diagnosing drug-associated bullous pemphigoid, enabling prompt management to be implemented. Bullous pemphigoid is an autoimmune subepithelial disease characterised by pruritus followed by urticarial plaques and finally bullae on the skin and mucosa. Drug-associated bullous pemphigoid (DABP) is a term used to describe instances of bullous pemphigoid demonstrating clinical, histological, or immunopathological features identical or similar to those of the idiopathic form of bullous pemphigoid, associated with the systemic ingestion, or topical application of particular drugs. In this study, we conducted a comprehensive search of the literature according to PRISMA guidelines and a total of 170 publications were included in the final qualitative analysis. In conclusion, 89 drugs were implicated in DABP. The strongest evidence for DABP is seen with gliptins, PD-1/PD-L1 inhibitors, loop diuretics, penicillin and derivatives. An appreciation of the medications associated with bullous pemphigoid enables clinicians to identify potential cases of DABP earlier and cease the offending medication.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of Drug-Induced Pemphigoid

Verheyden

Temel²,

Murrell³

2020

Acta Derm Venereol

102

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“…Most sulfa-containing drugs (including furosemide & sulfamethoxazole), hydrochlorothiazide, nonsteroidal antiinflammatory drugs, lisinopril, captopril, and losartan have been implicated having associations with the development of BP. 22 The bullous dermatosis of hemodialysis, first described in 1975 by Barbara and Rowe, is characterized by blisters on sun-exposed parts of the scalp, face, arms, and the dorsum of the hand. 19 Quite on the contrary, mammalian target of rapamycin inhibitor (mTOR) inhibitor therapy has been specifically associated with BP lesions in renal transplant recipients, despite the IS properties of the drug.…”

Section: Discussionmentioning

confidence: 99%

“…19 Quite on the contrary, mammalian target of rapamycin inhibitor (mTOR) inhibitor therapy has been specifically associated with BP lesions in renal transplant recipients, despite the IS properties of the drug. 22 The bullous dermatosis of hemodialysis, first described in 1975 by Barbara and Rowe, is characterized by blisters on sun-exposed parts of the scalp, face, arms, and the dorsum of the hand. 23 These skin lesions resemble those of porphyria cutanea tarda both clinically and histologically, and have been seen with chronic ambulatory peritoneal dialysis and chronic hemodialysis for years.…”

Section: Discussionmentioning

confidence: 99%

New diagnosis of bullous pemphigoid after withdrawal of immunosuppressive therapy in a failed renal transplant recipient on hemodialysis

Salim

Thomas

Quorles

et al. 2017

Hemodialysis International

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The occurrence of the autoimmune blistering disease, bullous pemphigoid (BP), in patients with failed renal allograft is rare and the few reported cases suggest various provocative factors without reaching a consensus. Here we report the case of a patient presenting with bullous lesions soon after the complete discontinuation of immunosuppressant therapy following renal allograft failure. Skin biopsy confirmed the diagnosis of BP. Administration of systemic corticosteroid controlled the occurrence of BP lesions in our patient. Increased clinical suspicion is warranted in cases of patients with renal transplant failure, since withdrawal of the immunosuppressant therapy could lead to unmasking the underlying autoimmune skin disease.

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“…Id reactions can rarely be seen in the morphology of urticaria, follicules, papules, erythema multiforme, erythema annulare centrifugum, and erythema nodosum (10). Atzori et al presented a 37-year-old male patient with erythema multiforme-like Id reaction that developed on the distal portion of the extremity due to tinea infection on the nose (11). Castriota et al reported an erythema nodosum-like Id reaction in the lower extremity of a nine-year-old girl diagnosed with TP and stated that the clinical findings were relieved by antifungal therapy (12).…”

Section: Discussionmentioning

confidence: 99%

A Rare Complication of Tinea Capitis: Urticarial Id Reaction

Kızılyel¹,

Elmas²,

Görgün³

et al. 2017

J Pediatr Inf

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Tinea capitis that usually affects prepubertal age group of children is a dermatophyte causes superficial fungal infection of hair follicle and follicle surroundings. Id reaction is a rare condition and considered to be a delayed hypersensitivity reaction opposed to dermatophyte antigens. It is usually seen as papular and vesicular morphologies. Urticarial id reaction is extremely rare. In here, we have reported two cases of urticarial id reaction caused by tinea capitis profunda and we pointed out that tinea capitis may be an etiological factor of urticarial reactions. We have presented this case because the clinical entity is extremely rare.

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Bullous pemphigoid induced by m‐TOR inhibitors in renal transplant recipients

Cited by 13 publications

References 14 publications

A Systematic Review of Drug-Induced Pemphigoid

A Systematic Review of Drug-Induced Pemphigoid

New diagnosis of bullous pemphigoid after withdrawal of immunosuppressive therapy in a failed renal transplant recipient on hemodialysis

A Rare Complication of Tinea Capitis: Urticarial Id Reaction

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