Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Drug-Induced Bullous Pemphigoid Associated with the Severe Acute Respiratory Syndrome-Coronavirus Disease 2019 Vaccine: Case Report

  • Hyun-Jeong Park (Department of Oral Medicine, College of Dentistry, Chosun University) ;
  • Ji Hoo Kim (Department of Oral Medicine, Chosun University Dental Hospital) ;
  • Jong-Mo Ahn (Department of Oral Medicine, College of Dentistry, Chosun University) ;
  • Ji-Won Ryu (Department of Oral Medicine, College of Dentistry, Chosun University)
  • Received : 2023.08.24
  • Accepted : 2023.09.05
  • Published : 2023.09.30
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Abstract

In this study, we investigate the emergence of bullous pemphigoid (BP) after the administration of the Severe Acute Respiratory Syndrome-Coronavirus Disease 2019 (SARSCOVID-19) vaccine. The study presents two cases of women, aged 47 and 53, diagnosed with BP following SARS-COVID-19 vaccination. BP is a common autoimmune blistering disorder prevalent among older populations, with an incidence rate ranging from 2 to 40 cases per million individuals. This condition arises when autoantibodies target adhesive proteins in the skin, resulting in blister formation and mucosal erosion. Drug-induced bullous pemphigoid (DIBP) shares similarities with the classic form of BP but may be influenced by medication usage. Notably, DIBP exhibits distinct characteristics, such as affecting a younger demographic and involving mucosal regions more prominently than classic BP. The growing incidence of BP is linked to factors such as an aging population and the rise of drug-induced cases. This case report provides valuable insights into comprehending DIBP, elucidating post-vaccination discomforts, particularly those related to oral lesions and the exacerbation of existing lesions. By elucidating these aspects, we aim to advance the understanding of DIBP within the medical community.

Keywords

Acknowledgement

This study was supported by a research fund from Chosun University Dental Hospital in 2021.

References

  1. Miyamoto D, Santi CG, Aoki V, Maruta CW. Bullous pemphigoid. An Bras Dermatol 2019;94:133-146. https://doi.org/10.1590/abd1806-4841.20199007
  2. Bagci IS, Horvath ON, Ruzicka T, Sardy M. Bullous pemphigoid. Autoimmun Rev 2017;16:445-455. https://doi.org/10.1016/j.autrev.2017.03.010
  3. Verheyden MJ, Bilgic A, Murrell DF. A systematic review of drug-induced pemphigoid. Acta Derm Venereol 2020;100:1-9. https://doi.org/10.2340/00015555-3457
  4. Moro F, Fania L, Sinagra JLM, Salemme A, Di Zenzo G. Bullous pemphigoid: trigger and predisposing factors. Biomolecules 2020;10:1432.
  5. Hassine HI. Covid-19 vaccines and variants of concern: a review. Rev Med Virol 2022;32:e2313.
  6. Zhang Y, Lang X, Guo S, He H, Cui H. Bullous pemphigoid after inactivated COVID-19 vaccination: case report. Dermatol Ther 2022;35:e15595.
  7. Di Spirito F, Caggiano M, Di Palo MP, et al. Oral lesions in pediatric subjects: SARS-CoV-2 infection and COVID-19 vaccination. Appl Sci 2022;12:8995.
  8. Martora F, Ruggiero A, Battista T, Fabbrocini G, Megna M. Bullous pemphigoid and COVID-19 vaccination: Management and treatment reply to 'Bullous pemphigoid in a young male after COVID-19 mRNA vaccine: a report and brief literature review' by Pauluzzi et al. J Eur Acad Dermatol Venereol 2023;37:e35-e36. https://doi.org/10.1111/jdv.18503
  9. Perez-Lopez I, Moyano-Bueno D, Ruiz-Villaverde R. Bullous pemphigoid and COVID-19 vaccine. Med Clin (Engl Ed) 2021;157:e333-e334. https://doi.org/10.1016/j.medcle.2021.05.004
  10. Aashish, Rai A, Khatri G, Priya, Hasan MM. Bullous pemphigoid following COVID-19 vaccine: an autoimmune disorder. Ann Med Surg (Lond) 2022;80:104266.
  11. Dell'Antonia M, Anedda S, Usai F, Atzori L, Ferreli C. Bullous pemphigoid triggered by COVID-19 vaccine: rapid resolution with corticosteroid therapy. Dermatol Ther 2022;35:e15208.
  12. Maronese CA, Caproni M, Moltrasio C, et al. Bullous pemphigoid associated with COVID-19 vaccines: an Italian multicentre study. Front Med (Lausanne) 2022;9:841506.
  13. Hammers CM, Stanley JR. Mechanisms of disease: pemphigus and bullous pemphigoid. Annu Rev Pathol 2016;23:175-197. https://doi.org/10.1146/annurev-pathol-012615-044313
  14. Tomayko MM, Damsky W, Fathy R, et al. Subepidermal blistering eruptions, including bullous pemphigoid, following COVID-19 vaccination. J Allergy Clin Immunol 2021;148:750-751. https://doi.org/10.1016/j.jaci.2021.06.026
  15. Maronese CA, Di Zenzo G, Genovese G, et al. Reply to "New-onset bullous pemphigoid after inactivated Covid-19 vaccine: Synergistic effect of the Covid-19 vaccine and vildagliptin". Dermatol Ther 2022;35:e15496.
  16. Liu SD, Chen WT, Chi CC. Association between medication use and bullous pemphigoid: a systematic review and meta-analysis. JAMA Dermatol 2020;156:891-900. https://doi.org/10.1001/jamadermatol.2020.1587
  17. Ujiie H. What's new in the pathogeneses and triggering factors of bullous pemphigoid. J Dermatol 2023;50:140-149. https://doi.org/10.1111/1346-8138.16654
  18. Wan V, Chen D, Shiau CJ, Jung GW. Association between COVID-19 vaccination and bullous pemphigoid - a case series and literature review. SAGE Open Med Case Rep 2022;10:2050313X221131868.
  19. Stavropoulos PG, Soura E, Antoniou C. Drug-induced pemphigoid: a review of the literature. J Eur Acad Dermatol Venereol 2014;28:1133-1140. https://doi.org/10.1111/jdv.12366
  20. Borradori L, Van Beek N, Feliciani C, et al. Updated S2 K guidelines for the management of bullous pemphigoid initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2022;36:1689-1704. https://doi.org/10.1111/jdv.18220
  21. Di Lernia V, Casanova DM, Goldust M, Ricci C. Pemphigus vulgaris and bullous pemphigoid: update on diagnosis and treatment. Dermatol Pract Concept 2020;10:e2020050.
  22. Kridin K, Ludwig RJ. The growing incidence of bullous pemphigoid: overview and potential explanations. Front Med (Lausanne) 2018;20:220.