Reactivation of pemphigus by varicella zoster virus after anti‐CD20 treatment

Douard, P.; Delaumenie, S.; Pittoni, Julien; Assikar, S.; Matei, I.; Prudhomme, R. O.; Audevard, D.; Bédane, C.

doi:10.1111/ijd.14711

Cited by 3 publications

(6 citation statements)

References 6 publications

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“…13 Furthermore, the evidence of HSV DNA in the oral cavity has been associated with the refractory character of the pemphigus. 14 Also, antiviral treatment in patients with refractory pemphigus can lead to complete recovery of the bullous disease, 2 and oral administration of acyclovir has been proposed in sudden relapsed in pemphigus patients after a partial or complete clinical remission. 15 However, in some cases, viral colonization of autoimmune bullous lesions can be clinically and histopathologically silent.…”

Section: Discussionmentioning

confidence: 99%

“…7 Apart from epitope spreading, cross reaction is also a feasible mechanism, which could explain the PV remissions above mentioned after receiving antivirals. 2,3,15…”

Section: Discussionmentioning

confidence: 99%

“…There are many examples in the literature of an association between mucocutaneous viral infections and autoimmune bullous diseases. [1][2][3][4][5][6][7][8] Among them, cases of pemphigus vulgaris (PV) following varicella infection have been reported. 8 In some other cases, PV worsened after recurrent varicella.…”

Section: Introductionmentioning

confidence: 99%

“…8 In some other cases, PV worsened after recurrent varicella. 7 Still in some other examples, PV reactivated after Varicella Zoster virus (VZV) infection in patients under rituximab therapy, 2 with positive direct immunofluorescence (DIF) studies at the periphery of the vesicular lesions. Additionally, the production of anti-BP180 antibodies has been triggered in patients with bullous pemphigoid due to reactivation of VZV.…”

Section: Introductionmentioning

confidence: 99%

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Varicella Zoster With Pemphigus-like Reaction

Fernández-Flores

2022

The American Journal of Dermatopathology

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We present a case of a 55-year-old man with a rash on his right foot that was biopsied and diagnosed as a Varicella Zoster virus infection with an accompanying positive immunohistochemical study with antiviral antibodies. He concomitantly suffered from a Varicella Zoster virus meningitis. The skin biopsies not only showed clear histologic signs of viral cytopathic effects but also showed intercellular IgG and C3 intraepidermal staining by direct immunofluorescence study, findings which are typically consistent with pemphigus vulgaris. However, the patient did not have any history of pemphigus; there was no mucosal involvement, and serum antibodies to desmoglein 1 and 3 were negative. After discharge, the patient continued to have right-sided foot pain, and he continued the acyclovir treatment.

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Section: Discussionmentioning

confidence: 99%

“…7 Apart from epitope spreading, cross reaction is also a feasible mechanism, which could explain the PV remissions above mentioned after receiving antivirals. 2,3,15…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Varicella Zoster With Pemphigus-like Reaction

Fernández-Flores

2022

The American Journal of Dermatopathology

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“…Transmission of this viral family is usually via skin-to-skin contact or contact with bodily fluids of an infected individual. Potentially, lesions caused by HSV could lead to the exposure of intraepidermal epitopes to the immune system causing intercellular adhesion molecule antibody production, and thus the development of PV (62)(63)(64). In a paper by Senger et al, the link between PV and the various Herpesviridae was explored by evaluating levels of antiviral antibodies.…”

Section: Infectionsmentioning

confidence: 99%

The multifactorial complexities of autoimmune development in Pemphigus vulgaris: Critical evaluation of the role of environmental and lifestyle “exposome” factors

et al. 2023

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Pemphigus vulgaris (PV) is a potentially life-threatening blistering disorder characterized by autoantibodies directed against cell-cell adhesion molecules that serves as an excellent model to study human autoimmune development. Numerous studies have identified specific Human Leukocyte Antigen (HLA) genes, in particular DRB1*0402 and DQB1*0503, that confer disease risk. Although HLA is required, it is not sufficient for the initiation of disease. As with all autoimmune diseases, the etio-pathogenesis of PV is complex, meaning it is multifactorial. Susceptibility is polygenic, and the search for non-HLA disease-linked genes continues. Moreover, twin studies across autoimmune conditions indicate that non-genetic environmental and lifestyle factors, which can be collectively grouped under the term “exposome”, are also major contributors to disease development. The literature presents evidence for the potential role of multiple triggers such as medications, infections, stress, diet, immunizations, and sleep to influence the etiology, pathophysiology, and prognosis of PV. However, a clear understanding of the degree to which specific factors impact PV is lacking. In this investigation, we comprehensively review the environmental elements listed above and consider the strength of evidence for these factors. The overall goals of this work are to provide greater insights into the factors that influence disease susceptibility, disease development and disease course and ultimately help to better guide clinicians and inform patients in the management of PV.

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Rituximab

2020

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Reactivation of pemphigus by varicella zoster virus after anti‐CD20 treatment

Cited by 3 publications

References 6 publications

Varicella Zoster With Pemphigus-like Reaction

Varicella Zoster With Pemphigus-like Reaction

The multifactorial complexities of autoimmune development in Pemphigus vulgaris: Critical evaluation of the role of environmental and lifestyle “exposome” factors

Rituximab

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