Department of Dermatology, Peking University First Hospital, Beijing, China.
National Clinical Research Center for Skin and Immune Diseases, Beijing, China.
J Dermatol. 2023 Jul;50(7):956-959. doi: 10.1111/1346-8138.16765. Epub 2023 Mar 7.
Biological drugs, including IL-17A inhibitors, have become the first-line treating options for moderate to severe psoriasis, and reports show a beneficial effect of IL-17A inhibitors on bullous pemphigoid. Here, we report two cases of bullous pemphigoid in remission that experienced severe flares during treatment with two major IL-17A inhibitors, i.e., ixekizumab or secukinumab for their psoriasis vulgaris. The patient with bullous pemphigoid induced by secukinumab became very recalcitrant to control the relapse. This is by far the first and paradoxical report on the IL-17A inhibitors having a negative effect on bullous pemphigoid patients in previously stable status. Our reports of these two cases alert clinicians to be careful when using IL-17A in pemphigoid patients. We also suggest that patients with psoriasis vulgaris should be asked for a detailed history of pemphigoid and its BP180 autoantibodies status be checked before using these biologicals.
生物制剂，包括 IL-17A 抑制剂，已成为中重度银屑病的一线治疗选择，有报道称 IL-17A 抑制剂对大疱性类天疱疮有有益作用。在此，我们报告了两例寻常型银屑病患者在使用两种主要的 IL-17A 抑制剂（依奇珠单抗或司库奇尤单抗）治疗过程中出现严重发作的大疱性类天疱疮缓解病例。使用司库奇尤单抗诱导的大疱性类天疱疮患者对控制复发非常顽固。这是迄今为止首例也是矛盾的报告，表明 IL-17A 抑制剂对先前稳定状态的大疱性类天疱疮患者有负面影响。我们对这两个病例的报告提醒临床医生在使用 IL-17A 治疗大疱性类天疱疮患者时要小心。我们还建议在使用这些生物制剂之前，应详细询问患者是否有大疱性类天疱疮病史，并检查其 BP180 自身抗体状态。
