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SARS-CoV-2 vaccine-triggered conversion from systemic lupus erythematosus (SLE) to bullous SLE and dipeptidyl peptidase 4 inhibitors-associated bullous pemphigoid.
Nakahara, Yukiko; Yamane, Mariko; Sunada, Midori; Aoyama, Yumi.
  • Nakahara Y; Department of Dermatology, Kawasaki Medical School, Okayama, Japan.
  • Yamane M; Department of Dermatology, Kawasaki Medical School, Okayama, Japan.
  • Sunada M; Department of Dermatology, Kawasaki Medical School, Okayama, Japan.
  • Aoyama Y; Department of Dermatology, Kawasaki Medical School, Okayama, Japan.
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.
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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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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