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Bullous pemphigoid induced by PUVA therapy
S Perl1, K Rappersberger, D Födinger
1Division of Special and Environmental Dermatology, University of Vienna, Austria.
Dermatology (Basel, Switzerland)
|January 1, 1996
Summary
This study reports the first case of psoriasis-associated bullous pemphigoid (BP) triggered by PUVA therapy. Immunoblotting confirmed BP antigens, suggesting UV light may precipitate these blistering skin conditions.
Area of Science:
- Dermatology
- Immunodermatology
- Photodermatology
Background:
- Psoriasis is a chronic inflammatory skin condition.
- PUVA therapy (psoralen plus UVA light) is a common treatment for psoriasis.
- Bullous pemphigoid (BP) is an autoimmune blistering disease.
Observation:
- An 80-year-old patient with psoriasis developed a blistering eruption during oral PUVA therapy.
- Histopathology showed subepidermal blistering.
- Direct and indirect immunofluorescence confirmed IgG, IgM, and C3 deposits at the basement membrane zone, with IgG binding to the epidermal side.
Findings:
- Immunoblotting identified BP antigens I and II.
- Phototesting with 8-methoxypsoralen reproduced the lesions.
- Histopathological and immunopathological findings were consistent with PUVA-induced BP.
Implications:
- This is the first report of psoriasis-associated BP confirmed by immunoblotting.
- UV light's role in precipitating bullous lesions in BP warrants further investigation.
- Potential for UV radiation to cause non-specific epidermal injury, attracting autoantibodies to the basement membrane zone, needs clarification.