University of Minnesota Medical School, Minneapolis, MN, USA.
Department of Dermatology, University of Minnesota, 516 Delaware St SE, MMC 98, Minneapolis, MN, 55455, USA.
J Med Case Rep. 2023 Sep 26;17(1):408. doi: 10.1186/s13256-023-04146-y.
Autoimmune bullous disorders develop due to autoantibodies targeting intercellular adhesion proteins of hemidesmosomes and desmosomes and may be triggered by viral infections and vaccines. Recent reports suggest that the coronavirus disease 2019 vaccination may trigger flares or exacerbations of preexisting autoimmune diseases, including new onset autoimmune bullous disorders. There are less data on whether vaccination against severe acute respiratory syndrome coronavirus 2 may also exacerbate preexisting autoimmune bullous disorders.
Here we present three cases, two white males (ages 69 years and 88 years) with bullous pemphigoid and one white 50-year-old female with pemphigus foliaceus, wherein all individuals developed minor, tractable flares of their preexisting autoimmune bullous disorders after receiving the coronavirus disease 2019 vaccination, which were readily treatable with topical or low-dose systemic corticosteroids.
Dermatologists managing patients with autoimmune bullous disorders should be cognizant of the uncommon potential for flares of the disorder following vaccination for severe acute respiratory syndrome coronavirus 2. Flares of bullous pemphigoid and pemphigus foliaceus following vaccination for severe acute respiratory syndrome coronavirus 2 in these cases were mild and tractable.
自身免疫性大疱性疾病是由于针对桥粒和半桥粒细胞间黏附蛋白的自身抗体而发展起来的，可能由病毒感染和疫苗引发。最近的报告表明，COVID-19 疫苗接种可能引发先前存在的自身免疫性疾病（包括新发自身免疫性大疱性疾病）的发作或恶化。关于严重急性呼吸综合征冠状病毒 2 疫苗接种是否也会加重先前存在的自身免疫性大疱性疾病的数据较少。
在此，我们介绍了三例病例，两例为白人男性（年龄分别为 69 岁和 88 岁），患有大疱性类天疱疮，一例为白人 50 岁女性，患有落叶型天疱疮，所有患者在接种 COVID-19 疫苗后均出现原有自身免疫性大疱性疾病的轻度、可控性发作，易于用局部或低剂量全身皮质类固醇治疗。
管理自身免疫性大疱性疾病患者的皮肤科医生应意识到在接种严重急性呼吸综合征冠状病毒 2 疫苗后该疾病发作的罕见可能性。在这些病例中，大疱性类天疱疮和落叶型天疱疮在接种严重急性呼吸综合征冠状病毒 2 疫苗后的发作是轻度且可控的。
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