SARS-CoV-2 vaccine-triggered conversion from systemic lupus erythematosus (SLE) to bullous SLE and dipeptidyl peptidase 4 inhibitors-associated bullous pemphigoid.
J Dermatol
; 50(2): 162-165, 2023 Feb.
Article
in English
| MEDLINE | ID: covidwho-2192133
ABSTRACT
Bullous systemic lupus erythematosus (BSLE) is a rare blistering disease in patients with SLE. BSLE is a heterogenous disease caused by autoantibodies to the basement membrane, mainly type VII collagen. The pathogenesis of the development of autoantibodies in BSLE remains unknown. We report a case of SLE taking dipeptidyl peptidase 4 inhibitors (DPP4i) who developed tense blister lesions after administration of SARS-CoV-2 vaccine. Initial erythematous lesion before administration of SARS-CoV-2 vaccine had not shown IgG deposition at basement membrane both direct and indirect immunofluorescence (IIF). However, the result of those examinations became positive after the administration of SARS-CoV-2 vaccine. Furthermore, IIF test results using NaCl split skin had shown positive against epidermal side. These observations suggest that SARS-CoV-2 vaccination triggered production of autoantibodies that cause bullous SLE. The present case fulfills the diagnostic criteria for both BSLE and DPP4i-associated bullous pemphigoid. Skin lesions were cleared after withdrawal of DPP4i. Therefore, physicians should ask patients who develop blisters after the vaccination whether they are taking DPP4i.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Lupus Erythematosus, Cutaneous
/
Pemphigoid, Bullous
/
Dipeptidyl-Peptidase IV Inhibitors
/
COVID-19 Vaccines
/
COVID-19
/
Lupus Erythematosus, Systemic
Type of study:
Case report
/
Diagnostic study
/
Observational study
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Limits:
Humans
Language:
English
Journal:
J Dermatol
Year:
2023
Document Type:
Article
Affiliation country:
1346-8138.16687
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