Severe pemphigus vulgaris and cervical carcinoma treated with anti PD1 antibody pembrolizumab: A therapeutic dilemma?

Managing autoimmune diseases (AIDs) in the context of malignancies and vice versa is an intricate challenge for clinicians. Immunotherapies stimulate antitumor immune responses by blocking checkpoint molecules such as PD1. However, new onset or aggravation of autoimmune reactions are frequent side effects of immunotherapies. Pemphigus vulgaris (PV) is a severe blistering autoimmune-mediated skin disease requiring immune-suppressive therapy. Here, we present a case, wherein a patient with severe PV underwent rituximab therapy, while simultaneously a newly diagnosed advanced cervical carcinoma was treated with pembrolizumab.