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Prehosp Disaster Med 2018 Jun 22:1-3. Epub 2018 Jun 22.

2Bégin Military Teaching Hospital,Saint-Mandé,France.

A seven-month-old girl was referred to the emergency department (ED) after a general practitioner suspected Steven-Johnson syndrome. Actually, the diagnosis of bullous pemphigoid (BP) was made based on biopsies; BP is a rare, autoimmune skin disease involving the presence of blisters known as bullae. The child was efficiently treated with topical steroids. Read More

Case Rep Dermatol 2018 May-Aug;10(2):145-148. Epub 2018 May 24.

Department of Dermatology, University Medical Center Regensburg, Regensburg, Germany.

Bullous pemphigoid (BP) is a blistering autoimmune disease mainly observed in elderly patients. Several triggers are known for this autoimmune disease and some drugs are known to be a cause of BP. However, there are only few case reports on the induction of BP under adalimumab therapy. Read More

An Bras Dermatol 2018 Jun;93(3):435-437

Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

Linear immunoglobulin A bullous dermatosis is a rare autoimmune disease that usually has an excellent prognosis in childhood; however, its control is more difficult in adults. It presents heterogeneous clinical manifestations and is frequently confused with other bullous diseases such as bullous pemphigoid and Duhring's dermatitis herpetiformis. Dermatologists' awareness of this disease contributes to early diagnosis and appropriate treatment. Read More

J Diabetes Investig 2018 Jun 19. Epub 2018 Jun 19.

Department of Diabetology and Nephrology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.

Aim/introduction: Bullous pemphigoid (BP) may be drug-induced. This study evaluated the relation between BP and dipeptidyl peptidase-4 inhibitors (DPP4Is).

Materials And Methods: We recruited patients diagnosed with BP at Ogaki Municipal Hospital from December 1, 2009 through December 31, 2017. Read More

J Clin Psychopharmacol 2018 Jun 14. Epub 2018 Jun 14.

McMaster UniversityHamilton, Ontario Canada. Department of Psychiatry and Behavioural NeurosciencesDivision of Geriatric PsychiatryMichael G. DeGroote School of MedicineFaculty of Health SciencesMcMaster University Hamilton, Ontario Canada Department of Psychiatry Baylor Scott & White HealthCentral Texas Divisionand Department of Psychiatry Texas A&M University Health Science Center College of Medicine Texas A&M University Temple, TX.

J Am Acad Dermatol 2018 Jun 12. Epub 2018 Jun 12.

Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China. Electronic address:

Dermatol Online J 2018 Apr 15;24(4). Epub 2018 Apr 15.

Department of Dermatology, University of California Davis School of Medicine, Sacramento, California.

As the list of anti-tumor immunotherapy agents and the list of cancers treated by these novel agents grow, a subset of patients are experiencing immune-related adverse events as a result of prolonged stimulation of the immune system. Many different immune related adverse events including colitis, hepatitis, pneumonitis, thyroiditis, hypophysitis, and cutaneous reactions can result from blocking these inhibitory pathways. The full spectrum of cutaneous immune related adverse events secondary to checkpoint inhibitor therapy is still being defined. Read More

J Dermatol 2018 Jun 15. Epub 2018 Jun 15.

School of Public Health, University of Haifa, Haifa, Israel.

There are inconsistent data on mortality rates in patients with bullous pemphigoid (BP). Trends in mortality in BP throughout the years are yet to be established. The aim of the present study was to study the mortality in BP patients relative to the general population and to estimate trends in standardized mortality over the past 30 years. Read More

Exp Dermatol 2018 Jun 12. Epub 2018 Jun 12.

Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA.

Basophils are blood granulocytes and normally constitute less than 1% of blood peripheral leukocytes. Basophils share some morphological and functional similarities with mast cells, and basophils were once regarded as redundant and negligible circulating mast cells. However, recent studies reveal the indispensable roles of basophils in various diseases, including allergic and pruritic diseases. Read More

Front Immunol 2018 24;9:1030. Epub 2018 May 24.

Department of Dermatology, Referral Center for Autoimmune Bullous Diseases (MALIBUL), Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France.

Mucous membrane pemphigoids (MMPs) and bullous pemphigoid (BP) are autoimmune bullous diseases that share physiopathological features: both can result from autoantibodies directed against BP180 or BP230 antigens. An association has been reported between BP and intake of gliptins, which are dipeptidyl peptidase-IV inhibitors used to treat type 2 diabetes mellitus. Clinical and immunological differences have been reported between gliptin-induced BPs and classical BPs: mucosal involvement, non-inflammatory lesions, and target BP180 epitopes other than the NC16A domain. Read More

Front Med (Lausanne) 2018 9;5:139. Epub 2018 May 9.

Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan.

Bullous pemphigoid (BP) presenting with erythema plaques and tense blisters is the most frequent autoimmune bullous disease. Immunologically, BP is characterized by the presence of circulating anti-epidermal basement membrane zone (BMZ) antibodies. The autoantigens in BMZs targeted by patient's antibodies are mainly BP180 (type XVII collagen) and BP230. Read More

Proc Natl Acad Sci U S A 2018 Jun 4;115(25):6434-6439. Epub 2018 Jun 4.

Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599;

BP180, also known as collagen XVII, is a hemidesmosomal component and plays a key role in maintaining skin dermal/epidermal adhesion. Dysfunction of BP180, either through genetic mutations in junctional epidermolysis bullosa (JEB) or autoantibody insult in bullous pemphigoid (BP), leads to subepidermal blistering accompanied by skin inflammation. However, whether BP180 is involved in skin inflammation remains unknown. Read More

Immunol Res 2018 Jun;66(3):425-430

Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.

The association of dipeptidyl peptidase-4 inhibitors (DPP4is) with autoimmune diseases is controversial. While these agents were proposed as a novel therapeutic approach for several inflammatory diseases by blocking T cell proliferation and cytokine production, they were found to trigger inflammatroy bowel disease, inflammatory arthritis and bullous pemphigoid. Our objective is to examine the association between DPP4i and autoimmune diseases. Read More

Hum Antibodies 2018 May 11. Epub 2018 May 11.

Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: TNF-α -308G/A polymorphism has been investigated in few studies for an association with susceptibility to bullous pemphigoid (BP) and alopecia areata (AA). Yet, these findings had so far not been independently replicated, and no data on a possible association of TNFα -308G/A polymorphism with these diseases in Iranian population were available.

Objectives: In the present study, a possible effect of TNF-α -308G/A variation on susceptibility to BP or AA disease was evaluated. Read More

J Am Acad Dermatol 2018 May 24. Epub 2018 May 24.

PEDEGO Research Unit, University of Oulu; Department of Dermatology and Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland. Electronic address:

Background: Dipeptidyl peptidase-4 inhibitors (DPP-4i) used to treat diabetes have been reported to be associated with an increased risk of bullous pemphigoid (BP). There are no previous reports analyzing the risk of BP in patients using other diabetes medications.

Objective: To evaluate the association between diabetes medications other than DPP-4i and development of BP. Read More

Ann Allergy Asthma Immunol 2018 May 24. Epub 2018 May 24.

Allergy and Immunology Section, Louisiana State University Health Sciences Center, Shreveport, Louisiana. Electronic address:

Objective: Provide a brief overview of the clinical presentation, common offending agents, management, prognosis, and mortality of selected six high-risk drug rashes, namely Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), multiple drug hypersensitivity syndrome (MDH), acute generalized exanthematous pustulosis (AGEP), and drug-induced bullous pemphigoid (DIBP).

Data Sources: Review of published literature using PubMed, supplemented with authors' clinical experience.

Study Selections: The most recent clinically relevant literature was chosen, as well as older seminal works. Read More

Australas J Dermatol 2018 May 23. Epub 2018 May 23.

Department of Dermatology, Jichi Medical University, Shimotsuke, Japan.

J Invest Dermatol 2018 Jun;138(6):1249-1251

Department of Dermatology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA; Department of Microbiology and Immunology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Electronic address:

Bullous pemphigoid is an autoantibody-mediated skin blistering disease. Previous studies revealed that intravenous Ig is therapeutic in animal models of bullous pemphigoid by saturating the IgG-protective receptor FcRn, thereby accelerating degradation of pathogenic IgG. Sasaoka et al. Read More

Orphanet J Rare Dis 2018 May 22;13(1):83. Epub 2018 May 22.

Faculty of Medicine, University of New South Wales, Sydney, 2052, Australia.

Background: Epidermolysis bullosa (EB) and autoimmune blistering diseases (AIBD) describe a group of rare chronic dermatoses characterized by cutaneous fragility and blistering. Although uncommon, significant ocular surface disease (OSD) may occur in both and require ophthalmological assessment. Disease scoring systems have a critical role in providing objective and accurate assessment of disease severity. Read More

Acta Dermatovenerol Croat 2018 Apr;26(1):71-72

Sergio Santos-Alarcon, MD, Department of Dermatology, , Hospital Universitario Doctor Peset, Avinguda Gaspar Aguilar Nº 90, 4601 Valencia, Spain;

Dear Editor, Gestational pemphigoid (GP) is a rare autoimmune bullous dermatosis in pregnancy. GP usually occurs during the second or third month of pregnancy. It clinically manifests as the development of either early-onset urticarial lesions or late-onset subepidermal blisters that may linger for weeks or even months. Read More

Am J Ophthalmol Case Rep 2018 Jun 24;10:145-147. Epub 2018 Feb 24.

Kentucky Lions Eye Center, University of Louisville, Louisville, KY, USA, 40202.

Purpose: To report a case of disseminated Nocardiosis with retinal and intracranial lesions.

Observations: A 49-year-old woman immunosuppressed because of treatment given for bullous pemphigoid presented with altered mental status and multiple intracranial lesions on imaging. The patient was found to have multiple retinal lesions in both eyes, including a subretinal abscess in the right eye. Read More

G Ital Dermatol Venereol 2018 Aug;153(4):588-590

Department of Medical-Surgical Physiopathology and Transplantation, University of Milan, Milan, Italy.

World J Oncol 2018 Apr 1;9(2):62-65. Epub 2018 May 1.

Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.

While the recent development of novel therapeutics in oncology, such as small molecule kinase inhibitors (SMKIs), has enabled our ability to target disease-specific molecular pathways, the prolonged impact of these agents on the immune system and infectious risk remains to be seen. We present a 68-year-old male with refractory chronic lymphocytic leukemia (CLL) on ibrutinib monotherapy for 3 years who developed extensive cutaneous mucormycosis following a severe bullous pemphigoid (BP) flare. He received amphotericin B for 4 weeks and was continued on posaconazole with resolution of his mucormycosis infection. Read More

Br J Dermatol 2018 May 14. Epub 2018 May 14.

Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Josef-Schneider-Strasse 2, 97080, Würzburg, Germany.

the anti-programmed death-1 (PD-1) antibody pembrolizumab, routinely used for treatment of metastatic melanoma or non-small cell lung cancer, was recently shown to have clinical meaningful activity in metastatic Merkel cell carcinoma (MCC). Several cases of bullous pemphigoid (BP) induced by PD-1 antibodies in melanoma have been reported so far. Here we report a case of oral mucous membrane pemphigoid (MMP) - a previously unknown, severe immune-related adverse event (irAE) occurring during pembrolizumab therapy. Read More

Clin Exp Dermatol 2018 May 14. Epub 2018 May 14.

Department of Dermatology, University College Hospitals, London, UK.

Genital bullous pemphigoid (GBP) is a rare localized subset of bullous pemphigoid (BP). BP is characterized by autoantibodies against hemidesmosomes, which are involved in the structural integrity of the epidermis, and this results in subepidermal blistering. Typically, GBP affects women and children. Read More

Clin Pharmacol Ther 2018 May 8. Epub 2018 May 8.

Department of Clinical Pharmacology, Medical University of Vienna, Austria.

Aberrant activation of the classical complement pathway is the common underlying pathophysiology of orphan diseases such as bullous pemphigoid, antibody-mediated rejection of organ transplants, cold agglutinin disease and warm autoimmune haemolytic anaemia. Therapeutic options for these complement-mediated disorders are limited and BIVV009, a humanized monoclonal antibody directed against complement factor C1s, may be potentially useful for inhibition of the classical complement pathway. A phase-1, first-in-human, double-blind, randomized, placebo-controlled, dose-escalation trial of single and multiple doses of BIVV009 or placebo was conducted in 64 volunteers to evaluate safety, tolerability, pharmacokinetic, and pharmacodynamic profiles. Read More

Clin Cosmet Investig Dermatol 2018 24;11:187-194. Epub 2018 Apr 24.

Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Background: Autoimmune subepidermal bullous dermatoses have similar clinical features to those of a spectrum of immune reactants at the dermoepidermal junction (DEJ). It is difficult to obtain a precise diagnosis without an immunofluorescence assay because of their similar clinical presentations. The aim of this study was to describe the cellular cutaneous infiltration among autoimmune subepidermal bullous dermatoses. Read More

J Eur Acad Dermatol Venereol 2018 May 5. Epub 2018 May 5.

Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.

Background: Kaposi's sarcoma (KS) is a rare endothelial neoplasm caused by the human herpesvirus 8 (HHV-8). Its risk is increased in immunocompromised patients, including those undergoing immunosuppressive therapy for autoimmune bullous diseases. Conversely, HHV-8 infection has been hypothesized to be a triggering factor of bullous diseases, especially pemphigus. Read More

Front Immunol 2018 17;9:779. Epub 2018 Apr 17.

Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy.

Autoimmune blistering diseases are characterized by autoantibodies against structural adhesion proteins of the skin and mucous membranes. Extensive characterization of their autoantibody targets has improved understanding of pathogenesis and laid the basis for the study of antigens/epitopes diversification, a process termed epitope spreading (ES). In this review, we have reported and discussed ES phenomena in autoimmune bullous diseases and underlined their functional role in disease pathogenesis. Read More

Front Immunol 2018 16;9:639. Epub 2018 Apr 16.

Department of Pathology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands.

The complement system is a fundamental part of the innate immune system, playing a crucial role in host defense against various pathogens, such as bacteria, viruses, and fungi. Activation of complement results in production of several molecules mediating chemotaxis, opsonization, and mast cell degranulation, which can contribute to the elimination of pathogenic organisms and inflammation. Furthermore, the complement system also has regulating properties in inflammatory and immune responses. Read More

Front Immunol 2018 12;9:542. Epub 2018 Apr 12.

Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Bullous pemphigoid (BP) is a common autoimmune blistering disease in which autoantibodies mainly target the hemidesmosomal component BP180 (also known as type XVII collagen) in basal keratinocytes. Various triggering factors are known to induce BP onset, including radiotherapy, burns, ultraviolet exposure, surgery, and the use of dipeptidyl peptidase-IV inhibitors (DPP4i), which are widely used antihyperglycemic drugs. Here, we present a case of BP triggered by a thermal burn under medication with DPP4i. Read More

J Allergy Clin Immunol 2018 Apr 26. Epub 2018 Apr 26.

Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany. Electronic address:

Background: Autoimmune bullous diseases/dermatoses (AIBDs) are severe autoantibody-mediated skin diseases. The pathogenic relevance of autoreactive CD4 T cells for the induction of autoantibody production remains to be fully evaluated. Scurfy mice lack functional regulatory T (Treg) cells, experience spontaneous activation of autoreactive CD4 T cells, and display severe erosive skin lesions suggestive of AIBDs. Read More

J Allergy Clin Immunol 2018 Apr 26. Epub 2018 Apr 26.

Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. Electronic address:

Background: Regulatory T (Treg) cells play a crucial role in peripheral immune tolerance in multiple organs, including the skin. Thus far, the effect of peripheral immune tolerance failure on autoantibody-related autoimmune reactions to the skin is unclear.

Objective: We sought to elucidate the target autoantigens in the skin under the condition of Treg cell dysfunction caused by forkhead box P3 (Foxp3) gene mutations in scurfy mice and patients with immunodysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome. Read More

Acta Derm Venereol 2018 Apr 24. Epub 2018 Apr 24.

Department of Dermatology and Allergy, Hannover Medical School, DE-30625 Hannover, Germany.

Bullous pemphigoid (BP) is characterized by substantial skin and blood eosinophilia as well as intensive pruritus. Since the pruritogenic cytokine interleukin (IL)-31 is increased in inflammatory skin diseases the aim of this study was to determine whether IL-31 plays a role in BP. Using immunofluorescence, IL-31 expression was analysed in eosinophils derived from blister fluids and skin from patients with BP and IL-31 levels in blister fluids, serum and culture supernatants were determined by enzyme-linked immunoassay (ELISA). Read More

JAAD Case Rep 2018 May 4;4(4):352-354. Epub 2018 Apr 4.

Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea.

Front Immunol 2018 9;9:689. Epub 2018 Apr 9.

Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.

The study of autoimmunity mediated by immunoglobulin E (IgE) autoantibodies, which may be termed autoallergy, is in its infancy. It is now recognized that systemic lupus erythematosus, bullous pemphigoid (BP), and chronic urticaria, both spontaneous and inducible, are most likely to be mediated, at least in part, by IgE autoantibodies. The situation in other conditions, such as autoimmune uveitis, rheumatoid arthritis, hyperthyroid Graves' disease, autoimmune pancreatitis, and even asthma, is far less clear but evidence for autoallergy is accumulating. Read More

Int J Dermatol 2018 Jul 23;57(7):810-816. Epub 2018 Apr 23.

Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.

Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors have increasingly been identified as causative agents of bullous pemphigoid. The clinical and immunological characteristics of this pemphigoid variant are still unclear. The objective of our study was to analyze the clinical and immunological features of patients with pemphigoid induced by DPP-4 inhibitors. Read More

J Cutan Med Surg 2018 Apr 1:1203475418773359. Epub 2018 Apr 1.

1 Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Vancouver, BC, Canada.

Background: Bullous pemphigoid (BP) is the most common subepidermal autoimmune disorder characterized by tense bullae. It is associated with circulating autoantibodies against BP antigen-1 and BP antigen-2. Diagnosis is based upon clinical, histopathologic, and immunopathologic examination. Read More

Ann Dermatol Venereol 2018 May 18;145(5):313-330. Epub 2018 Apr 18.

Oncodermatologie, institut universitaire du cancer Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.

The development of immune checkpoint inhibitors (monoclonal antibodies targeting PD-1/PD-L1 or CTLA-4) represents a significant advance in the treatment of multiple cancers. Given their particular mechanism of action, which involves triggering CD4+/CD8+ T-cell activation and proliferation, they are associated with a specific safety profile. Their adverse events are primarily immune-related, and can affect practically all organs. Read More

Br J Dermatol 2018 Apr 16. Epub 2018 Apr 16.

Department of Dermatology, Rambam Health Care Campus, Haifa, Israel.

Background: Peripheral eosinophilia has been reported in 50-60% of bullous pemphigoid (BP) patients and correlated positively with disease severity. The association of peripheral eosinophilia with the different morphological characteristics of BP and the presence of tissue eosinophilia has not been established.

Methods: The study was designed as a case-control study. Read More

Front Immunol 2018 13;9:479. Epub 2018 Mar 13.

Laboratory of Dermatology, Faculty of Medicine, EA7319, University of Reims Champagne-Ardenne, Reims, France.

Bullous pemphigoid (BP) is the most common autoimmune bullous disease and typically affects the elderly. Binding of specific autoantibodies to BP180/230 hemidesmosomal components induces an inflammatory response leading to skin blister formation. Unusual manifestations of BP include additional mucous membrane involvement, without pathophysiological knowledge associated to the formation of these lesions. Read More

Medicine (Baltimore) 2018 Apr;97(15):e0377

Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea.

Introduction: Bullous pemphigoid is a type of acute or chronic autoimmune disease that involves subepidermal skin lesions with bulla formation. Although viral infections, such as, human herpes virus (HHV), human immunodeficiency virus, cytomegalovirus, Epstein-Barr virus, HHV-6, hepatitis B virus (HBV), and hepatitis C virus (HCV), are known factors of bullous pemphigoid, HCV infection has only been rarely associated factor, especially in HBV endemic area. A 78-year-old man was admitted to our hospital due to erythematous bulla of onset 3 months before presentation affecting his entire body. Read More

Rev Esp Geriatr Gerontol 2018 Apr 7. Epub 2018 Apr 7.

Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.

Autoimmun Rev 2018 Jun 7;17(6):576-581. Epub 2018 Apr 7.

Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania 'Luigi Vanvitelli', Via de Crecchio 6, 80138 Naples, Italy. Electronic address:

Scientific and clinical data indicate that human herpes simplex virus 1 (HSV1) and, at a lesser extent, human herpes simplex virus 2 (HSV2) are factor(s) implicated in the development of erythema multiforme (EM). With a focus on oral EM, the present structured review of proteomic and epitope databases searched for the molecular basis that might link HSV1 and HSV2 infections to EM. It was found that a high number of peptides are shared between the two HSVs and human proteins related to the oral mucosa. Read More

Int J Dermatol 2018 Jun 6;57(6):664-669. Epub 2018 Apr 6.

Department of Dermatology, Columbia University Medical Center, New York, NY, USA.

Background: Dermatologic toxicity represents a substantial portion of all immune-related adverse events (irAEs) associated with PD-1/PD-L1 inhibitors. Bullous pemphigoid (BP) is a rare cutaneous side effect of these medications, which can initially be clinically indistinguishable from other, low-grade cutaneous toxicity.

Objective: To better characterize the clinical features of BP associated with PD-1/PD-L1 inhibitors, evaluate the efficacy of various treatment regimens, determine the frequency of prodromal pruritus, and assess whether immunological diagnostic studies for BP are warranted in patients treated with checkpoint inhibitors who develop intractable pruritus. Read More

BMJ Case Rep 2018 Apr 7;2018. Epub 2018 Apr 7.

Department of Pathology and Laboratory Medicine, University of Miami School of Medicine, Miami, Florida, USA.

Methotrexate toxicity in mucocutaneous areas is usually not associated with tissue eosinophilia. We describe a case of acute methotrexate-induced mucocutaneous erosions with interface dermatitis and eosinophils. A 76-year-old African-American woman with a history of bullous pemphigoid on methotrexate therapy presented with lower extremity cellulitis, developing oral and cutaneous erosions during hospitalization after daily dosage of methotrexate. Read More

J Allergy Clin Immunol 2018 Apr 4. Epub 2018 Apr 4.

Department of Dermatology and Allergology, Philipps-University, Marburg, Germany. Electronic address:

Int J Dermatol 2018 Apr 6. Epub 2018 Apr 6.

Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Br J Dermatol 2018 Apr 6. Epub 2018 Apr 6.

Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Bullous pemphigoid (BP) is a common autoimmune blistering disorder in which autoantibodies (autoAbs) target two hemidesmosomal components (BP180/collagen XVII and BP230) in basal keratinocytes, and 80 to 90% of BP cases have autoAbs targeting the juxtamembranous extracellular NC16A domain of BP180 (anti-BP180 NC16A autoAbs). Recently, increasing numbers of BP cases associated with the administration of dipeptidyl peptidase-IV inhibitors (DPP4i) for the treatment of type II diabetes have been reported, although the association remains controversial. Our recent reports suggested that DPP4i-associated BP (DPP4i-BP) tends to show a "non-inflammatory" phenotype characterized by no or mild erythema, and these DPP4i-BP patients have autoAbs that preferentially target the mid-portion of the extracellular domain of BP180 but not the NC16A domain. Read More