Rituximab-induced autoimmune dermatoses in patients with pemphigus
DOI:
https://doi.org/10.47196/m2et9615Keywords:
pemphigus vulgaris, pemphigus foliaceus, rituximab, immune dysregulation, lichen striatus, psoriasiform dermatosisAbstract
Rituximab is a monoclonal antibody directed against CD20 that induces B-cell depletion and represents an effective treatment for pemphigus. However, its use has infrequently been associated with the development of secondary autoimmune dermatoses, possibly related to alterations in immune regulation following B-cell depletion and a transient imbalance between B- and T-cell immunity. We present two cases of patients with pemphigus- one vulgar and the other foliaceus, seborrheic variant -who developed, respectively, lichen striatus and a psoriasiform dermatosis following anti-CD20 therapy. These manifestations occurred in the context of the disease course and adjustments in systemic immunosuppression. The possible immunopathogenic mechanisms involved are discussed, and the available literature is reviewed. Recognition of these reactions, although uncommon, is important for appropriate management and to avoid diagnostic confusion.
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