Bullous pemphigoid: case report A 65-year-old man developed bullous pemphigoid during treatment with ipilimumab and nivolumab for metastatic melanoma. The man, who had a medical history of metastatic melanoma, presented with worsening of pruritic and erythematous rash for 3 months. He had previosuly completed treatment with ipilimumab and had been receiving nivolumab injection. The rash was exacerbated by successive monthly nivolumab injections with severe flare occurring after the most recent nivolumab injection. Physical examination showed scattered, erythematous, maculopapular lesions in various stages of healing with secondary crusting and excoriation. Histopathological investigation of a skin punch biopsy including direct immunofluorescence showed linear deposition of C3 and IgG on the basement membrane. All these were consistent with bullous pemphigoid. His anti-BP-180 autoantibodies were found to be increased. Subsequently, nivolumab was stopped, and the man was treated with dapsone, unspecified antihistamines and unspecified steroids. Eventually, the rash improved. Later, it was confirmed that his bullous pemphigoid was associated with ipilimumab and nivolumab.
{"title":"Bullous pemphigoid.","authors":"Bronwyn Southwell, A. Khachemoune","doi":"10.32388/zs88q7","DOIUrl":"https://doi.org/10.32388/zs88q7","url":null,"abstract":"Bullous pemphigoid: case report A 65-year-old man developed bullous pemphigoid during treatment with ipilimumab and nivolumab for metastatic melanoma. The man, who had a medical history of metastatic melanoma, presented with worsening of pruritic and erythematous rash for 3 months. He had previosuly completed treatment with ipilimumab and had been receiving nivolumab injection. The rash was exacerbated by successive monthly nivolumab injections with severe flare occurring after the most recent nivolumab injection. Physical examination showed scattered, erythematous, maculopapular lesions in various stages of healing with secondary crusting and excoriation. Histopathological investigation of a skin punch biopsy including direct immunofluorescence showed linear deposition of C3 and IgG on the basement membrane. All these were consistent with bullous pemphigoid. His anti-BP-180 autoantibodies were found to be increased. Subsequently, nivolumab was stopped, and the man was treated with dapsone, unspecified antihistamines and unspecified steroids. Eventually, the rash improved. Later, it was confirmed that his bullous pemphigoid was associated with ipilimumab and nivolumab.","PeriodicalId":77103,"journal":{"name":"Dermatology nursing","volume":"21 1 1","pages":"37"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41841256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Allergic contact dermatitis (ACD) is a common skin disease caused by a T cell-mediated immune reaction to usually innocuous allergens. ACD can have grave medical and socioeconomic consequences. ACD and irritant contact dermatitis often occur together. A detailed history and clinical examination are crucial and guide patch testing, which is the gold standard to diagnose ACD. T-cell clones persisting in the skin may explain the tendency of ACD to relapse even after years of allergen avoidance. Traditional treatments for ACD are topical steroids, calcineurin inhibitors, phototherapy, retinoids (including the recent alitretinoin), and immunosuppressants. Targeted therapies are lacking. DOI: https://doi.org/10.1016/j.iac.2016.08.014 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-130081 Journal Article Accepted Version The following work is licensed under a Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License. Originally published at: Kostner, Lisa; Anzengruber, Florian; Guillod, Caroline; Recher, Mike; Schmid-Grendelmeier, Peter; Navarini, Alexander A (2017). Allergic contact dermatitis. Immunology and Allergy Clinics of North America, 37(1):141-152. DOI: https://doi.org/10.1016/j.iac.2016.08.014 Allergic Contact Dermatitis Authors: Lisa Kostner (MD), Florian Anzengruber (MD), Caroline Guillod (MD), Peter SchmidGrendelmeier (MD) 1 and Alexander Navarini (MD, PhD) Author information Department of Dermatology, University Hospital Zurich, Zurich, Switzerland Corresponding author: alexander.navarini@usz.ch
{"title":"Allergic contact dermatitis.","authors":"J. Douglas","doi":"10.32388/vtlcb3","DOIUrl":"https://doi.org/10.32388/vtlcb3","url":null,"abstract":"Allergic contact dermatitis (ACD) is a common skin disease caused by a T cell-mediated immune reaction to usually innocuous allergens. ACD can have grave medical and socioeconomic consequences. ACD and irritant contact dermatitis often occur together. A detailed history and clinical examination are crucial and guide patch testing, which is the gold standard to diagnose ACD. T-cell clones persisting in the skin may explain the tendency of ACD to relapse even after years of allergen avoidance. Traditional treatments for ACD are topical steroids, calcineurin inhibitors, phototherapy, retinoids (including the recent alitretinoin), and immunosuppressants. Targeted therapies are lacking. DOI: https://doi.org/10.1016/j.iac.2016.08.014 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-130081 Journal Article Accepted Version The following work is licensed under a Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License. Originally published at: Kostner, Lisa; Anzengruber, Florian; Guillod, Caroline; Recher, Mike; Schmid-Grendelmeier, Peter; Navarini, Alexander A (2017). Allergic contact dermatitis. Immunology and Allergy Clinics of North America, 37(1):141-152. DOI: https://doi.org/10.1016/j.iac.2016.08.014 Allergic Contact Dermatitis Authors: Lisa Kostner (MD), Florian Anzengruber (MD), Caroline Guillod (MD), Peter SchmidGrendelmeier (MD) 1 and Alexander Navarini (MD, PhD) Author information Department of Dermatology, University Hospital Zurich, Zurich, Switzerland Corresponding author: alexander.navarini@usz.ch","PeriodicalId":77103,"journal":{"name":"Dermatology nursing","volume":"21 5 1","pages":"287-91"},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41995031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A recurrent purple discoloration of the skin that does not blanche and is found in a lacy, network pattern, most often in the lower extremities. It may be aggravated by exposure to cold and is classified as idiopathic or secondary. Secondary livedo reticularis may be a cutaneous manifestation of immune system disorders (e.g., lupus erythematosus, rheumatoid arthritis, cryoglobulinemia, lymphoma, etc), and hematologic disorders (polycythemia vera). Qeios · Definition, February 7, 2020
{"title":"Livedo reticularis.","authors":"Gabriele Muekusch, Judith Pitman","doi":"10.32388/edh4tl","DOIUrl":"https://doi.org/10.32388/edh4tl","url":null,"abstract":"A recurrent purple discoloration of the skin that does not blanche and is found in a lacy, network pattern, most often in the lower extremities. It may be aggravated by exposure to cold and is classified as idiopathic or secondary. Secondary livedo reticularis may be a cutaneous manifestation of immune system disorders (e.g., lupus erythematosus, rheumatoid arthritis, cryoglobulinemia, lymphoma, etc), and hematologic disorders (polycythemia vera). Qeios · Definition, February 7, 2020","PeriodicalId":77103,"journal":{"name":"Dermatology nursing","volume":"16 2 1","pages":"181"},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42757312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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