New Bullous Eruptions in a COVID-19 Positive Patient in an Intensive Care Unit
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Keywords
bullous pemphigoid, pauci-cellular, pauci-inflammatory, bullous, pemphigoid, viral, COVID-19, SARs-CoV-2, coronavirus
Abstract
Bullous pemphigoid (BP) is an autoimmune blistering disorder that typically occurs in older adults. The etiopathogenesis of BP is unclear, although viral triggers have been reported. We present a case of new onset pauci-cellular BP in a patient admitted to Intensive Care Unit from an acute COVID-19 infection. Our case proposes to add the new coronavirus to the list of potential viral triggers of BP. Moreover, clinicians should be aware that the same at-risk population for autoimmune bullous diseases may also be at-risk for COVID-19 infection that is responsible for the current pandemic.
References
2. Baroero L, Coppo P, Bertolino L, et al. Three case reports of post immunization and post viral Bullous Pemphigoid: looking for the right trigger. BMC Pediatr. 2017;17(1):60. Published 2017 Feb 23. doi:10.1186/s12887-017-0813-0
3. Ortega-Quijano D, Jimenez-Cauhe J, Selda-Enriquez G, et al. Algorithm for the classification of Covid-19 rashes, Journal of the American Academy of Dermatology (2020), doi: https://doi.org/10.1016/j.jaad.2020.05.034.
4. Freeman EE, McMahon DE, Lipoff JB, et al. Pernio-like skin lesions associated with COVID-19: a case series of 318 patients from 8 countries [published online ahead of print, 2020 May 29]. J Am Acad Dermatol. 2020;S0190-9622(20)30984-1. doi:10.1016/j.jaad.2020.05.109
5. Hiroyasu S, Ozawa T, Kobayashi H, et al. Bullous pemphigoid IgG induces BP180 internalization via a macropinocytic pathway. Am J Pathol. 2013;182(3):828-840. doi:10.1016/j.ajpath.2012.11.029
6. Iwata H, Kamio N, Aoyama Y, et al. IgG from patients with bullous pemphigoid depletes cultured keratinocytes of the 180-kDa bullous pemphigoid antigen (type XVII collagen) and weakens cell attachment. J Invest Dermatol. 2009;129(4):919-926. doi:10.1038/jid.2008.305
7. Azimi SZ, Firooz A, Murrell DF, et al. Treatment concerns for bullous pemphigoid in the COVID-19 pandemic era [published online ahead of print, 2020 Jul 4]. Dermatol Ther. 2020;e13956. doi:10.1111/dth.13956
8. Kasperkiewicz M, Schmidt E, Fairley JA, et al. Expert recommendations for the management of autoimmune bullous diseases during the COVID-19 pandemic [published online ahead of print, 2020 Apr 25]. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16525. doi:10.1111/jdv.16525
9. Carugno A, Sena P, Raponi F, Robustelli Test E, Vezzoli P. Patients with bullous skin disease in a high-epidemic COVID-19 area, Bergamo, Italy. Br J Dermatol. 2020;183(3):589-591. doi:10.1111/bjd.19266
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