Ustekinumab associated bullous pemphigoid in a psoriasis patient and a review of the literature

Ustekinumab associated bullous pemphigoid in a psoriasis patient and a review of the literature [Turkderm-Turk Arch Dermatol Venereol]

Turkderm-Turk Arch Dermatol Venereol. 2019; 53(1): 32-35 | DOI: 10.4274/turkderm.galenos.2018.11354

Ustekinumab associated bullous pemphigoid in a psoriasis patient and a review of the literature

Se�il Vural¹, Mustafa G�ndo�du¹, Pelin Ertop¹, Hatice �anl�¹, P�nar Korkmaz¹, Aylin Ok�u Heper², Nihal Kundak��¹
¹Ankara University Faculty of Medicine, Department of Dermatology, Ankara, Turkey
²Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey

Ustekinumab is a Food and Drug Administration-approved (2009) novel treatment for psoriasis patients. This anti-interleukin-12/23p40 monoclonal antibody is effective in the treatment of plaque psoriasis and psoriatic arthritis. Several drugs, including anti-tumor necrosis factoralpha agents, used for psoriasis have been reported to induce or cause bullous pemphigoid (BP). A psoriasis patient presented with bullous lesions appearing on the extremities, groin, and axillary region four weeks after ustekinumab therapy. The patient was diagnosed with druginduced BP. Ustekinumab was discontinued and the patient was treated with topical steroids and acitretin. The BP lesions did not recur in the twelve-month follow-up, after cessation of the steroids. Even though several drugs are related to the induction of BP, ustekinumab is included in this list recently. The resolution of BP after discontinuation of ustekinumab favors the diagnosis of drug-induced BP.

Keywords: Psoriasis, ustekinumab, adverse effect, bullous pemphigoid

Psoriazis hastas�nda ustekinumab ile ili�kili geli�en b�ll�z pemfigoid ve literat�r derlemesi

Se�il Vural¹, Mustafa G�ndo�du¹, Pelin Ertop¹, Hatice �anl�¹, P�nar Korkmaz¹, Aylin Ok�u Heper², Nihal Kundak��¹
¹Ankara �ni̇versi̇tesi̇ T�p Fak�ltesi̇ Dermatoloji̇ Ana Bi̇li̇m Dal�
²Ankara �ni̇versi̇tesi̇ T�p Fak�ltesi̇ Patoloji̇ Ana Bi̇li̇m Dal�

Ustekinumab, psoriazis hastalar� i�in G�da ve �la� �daresi taraf�ndan 2009 y�l�nda onaylanan yeni bir tedavi ajan�d�r. �nterl�kin-12/23��n p40 sub�nitini hedef alan bu monoklonal antikor, plak psoriazis ve psoriatik artrit tedavisinde etkilidir. Literat�rde �imdiye kadar anti-t�m�r nekroz fakt�r�-alfa grubu ila�lar�n da i�inde yer ald�� pek �ok ila� b�ll�z pemfigoid (BP) geli�iminden sorumlu tutulmu�tur. Klini�imize bir psoriazis hastas� ilk ustekinumab enjeksiyonundan d�rt hafta sonra ekstremiteler, kas�k ve aksillar b�lgede b�ll�z lezyonlar ile ba�vurdu. Hastaya ila�la ind�klenen BP tan�s� koyuldu. Ustekinumab kesildi ve hasta topikal steroid ve asitretin ile tedavi edildi. BP steroid kesilmesinden sonraki on iki ayl�k takipte tekrarlamad�. BP�ye sebep olan ila�lar�n oldu�u listeye ustekinumab �ok yak�n bir zamanda eklenmi�tir. Ustekinumab�n kesilmesinden sonra BP�nin tekrarlamamas� ila� ili�kili BP tan�s�n� desteklemektedir.

Anahtar Kelimeler: Psoriazis, ustekinumab, yan etki, b�ll�z pemfigoid

Se�il Vural, Mustafa G�ndo�du, Pelin Ertop, Hatice �anl�, P�nar Korkmaz, Aylin Ok�u Heper, Nihal Kundak��. Ustekinumab associated bullous pemphigoid in a psoriasis patient and a review of the literature. Turkderm-Turk Arch Dermatol Venereol. 2019; 53(1): 32-35

Corresponding Author: Se�il Vural, T�rkiye

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