Transient worsening of pemphigus vulgaris resembling toxic epidermal necrolysis after the first cycle of rituximab therapy

Abstract

spreading erythematous macules (that are not typical for PV) and flaccid blisters, TEN was suspected. Nevertheless, DIF and histology findings were consistent with PV. However, superinfection with Klebsiella pneumoniae prior to exacerbation in our patient fits with the results of a recent study showing that exacerbation of PV after rituximab was associated with more frequent secondary bacterial infections. 6 Further studies are needed to identify the factors that could predict this paradoxical reaction after rituximab treatment in PV patients. CONFLICT OF INTERESTThe authors declare that they have no conflict of interest. AUTHOR CONTRIBUTIONS Mislav Mokos: Analysis and interpretation of data, literature search, writing-original draft preparation, editing, final approval of the version to be published. Ines Lakoš Juki c: Analysis and interpretation of data, review and editing, final approval of the version to be published. Branka Marinovi c: Conceptualization, analysis and interpretation of data, literature search, review and editing, final approval of the version to be published. INFORMED CONSENTWritten informed consent was provided from the presented patient for the use of image and publication of the case details.