Autoimmune bullous disorder flares following severe acute respiratory syndrome coronavirus 2 vaccination: a case series

Background 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 exacerbat...

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Bibliographic Details
Published in:Journal of medical case reports 2023-09, Vol.17 (1), p.1-408, Article 408
Main Authors: Rasner, Cody J, Schultz, Brittney, Bohjanen, Kimberly, Pearson, David R
Format: Article
Language:English
Subjects:
Adalimumab
Antibodies
Autoantibodies
Autoimmune
Autoimmune diseases
Autoimmunity
Bullous pemphigoid
Case Report
Case reports
Coronaviruses
COVID
COVID-19 vaccines
Dermatology
Development and progression
Esophagus
Guillain-Barre syndrome
Histopathology
Immune system
Immunization
Influenza
Pandemics
Patients
Pemphigus
Proteins
Pruritus
Psoriasis
SARS-CoV-2
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Skin diseases
Steroids
Tetanus antitoxin
Vaccination
Viral infections
Virus diseases
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Summary:Background 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. Case presentation 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. Conclusions 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. Keywords: Bullous pemphigoid, Pemphigus, COVID, SARS-CoV-2, Vaccination, Autoimmune, Case report
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-023-04146-y