jkra The Journal of the Korean Rheumatism Association J Korean Rheum Assoc 1226-8070 2233-4718 The Korean Rheumatism Association 10.4078/jkra.2010.17.4.422 jkra-17-422 Original Article A Case of Bullous Pemphigoid Arising after Infliximab Therapy in a Patient with Rheumatoid Arthritis ParkSeong Oh LeeJi Hyun Department of Rheumatology, Maryknoll Hospital, Busan, Korea 122010 23122010 17 4 422 425 10062010 11082010 12082010 Copyright © 2010 The Korean Rheumatism Association 2010 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Bullous pemphigoid is an autoimmune, subepidermal blistering disease commonly seen in the elderly. It is known as autoimmune bullous dermatoses with an estimated prevalence of 1 in 40,000 and shows no gender or racial predilection. It has an autoimmune nature with immunoglobulin (Ig) G and/or C3 complement targeting hemidesmosomal antigens located in the epidermal basement membrane zone. Drug-induced pemphigoid, although rare, can occur in patients taking penicillamine, furosemide, captopril, penicillin, or sulfasalazine, but infliximab-induced pemphigoid has not been reported. We experienced a case of infliximab-induced pemphigoid in 54-year-old woman with a 17-year history of rheumatoid arthritis.

 InfliximabBullous pemphigoidRheumatoid arthritis REFERENCES Cleveland Clinic: Current Clinical Medicine 2009 1st ed. Chapter 44 Philadelphia, PA, Saunders 2009 Ferri FF Ferri's Clinical Advisor 2010 1st ed. 240 Philadelphia, PA, MOSBY 2010 Duong TA Buffard V AndreA C Ortonne N Revuz J Bagot M Efalizumab-induced bullous pemphigoid J Am Acad Dermatol 2010 62 1612 Rongioletti F Parodi A Rebora A Dyshidrosiform pemphigoid: report of an additional case Dermatologica 1985 170 84 Levine N Freilich A Barland P Localized pemphigoid simulating dyshidrosiform dermatitis Arch Dermatol 1979 115 3201 Tamai K Li K Uitto K Idendification of a DNA-binding protein (keratinocyte transcriptional protein-1) recognizing a keratinocyte-specific regulatory element in the 230 kDa bullous pemphigoid antigen gene J Biol Chem 1994 269 493502 Pfau A Hohenleutner U Hohenleutner S Eckert F Landthaler M UVA-provoked localized bullous pemphigoid Acta Derm Venereol 1994 74 3146 Bordignon M Belloni-Fortina A Pigozzi B Tarantello M Alaibac M Bullous Pemphigoid during Long-Term TNF-a Blocker Therapy Dermatology 2009 219 3578 Chang YT Liu HN Wong CK Bullous pemphigoid: a report of 86 cases from Taiwan Clin Exp Dermatol 1996 21 202 Heffernan MP Bentley DD Successful treatment of mucous membrane pemphigoid with infliximab Arch Dermatol 2006 142 126870 Figures

Multiple vesicles and erosion on groin.

Vesicle on third finger, left.

Subepidermal bullae was found with inflammatory infiltrates on the dermis (hematoxylin and eosin, ×100).

Immunofluorescent stain of patient's serum shows linear pattern of IgG deposition on the epidermal basement membrane of normal skin.