Severe bullous pemphigoid associated with pembrolizumab therapy for metastatic melanoma with complete regression.
Clin Exp Dermatol
; 42(3): 309-312, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-28211077
ABSTRACT
Bullous pemphigoid (BP) is considered to be a humorally mediated autoimmune disease, but autoreactive T-cells and T-regulatory cells (Tregs) have also been implicated in this disease. Tregs and the programmed death-1 (PD-1) programmed death ligand (PD-L) pathway are both critical in terminating immune response, and elimination of either can result in breakdown of tolerance and development of autoimmunity. We report a patient with metastatic malignant melanoma (MM), who underwent pembrolizumab (anti-PD-1) therapy following unsuccessful treatment with ipilimumab [anti-cytotoxic T-lymphocyte-associated protein (CTLA)-4]. The patient developed BP with increasing serum titres of anti-BP180 IgG autoantibodies and increasing disease severity during pembrolizumab therapy. High doses of corticosteroids and methotrexate were needed to control the BP. Following the termination of pembrolizumab therapy, imaging showed complete regression of all metastatic sites. This result may indicate a crucial role for T-cell suppressive activity in controlling and preventing BP.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Problema de saúde:
6_malignant_skin_melanoma
/
6_skin_diseases
Assunto principal:
Neoplasias Cutâneas
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Penfigoide Bolhoso
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Anticorpos Monoclonais Humanizados
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Melanoma
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Antineoplásicos
Tipo de estudo:
Risk_factors_studies
Limite:
Female
/
Humans
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Middle aged
Idioma:
En
Revista:
Clin Exp Dermatol
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Israel