{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T23:30:36Z","timestamp":1768001436165,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Immune checkpoint inhibitors including programmed cell death protein 1 (PD\u20101) antibody are used in major breakthrough therapies in cancer, however they cause unique adverse events, termed immune\u2010related adverse events (irAEs). Among the various dermatological irAEs, an autoimmune bullous disease, bullous pemphigoid (BP), the hallmarks of which are circulating autoantibodies to epidermal basement membrane zone (BMZ) including BP180, have been noted. However, the mechanism and timing of autoantibody production in PD\u20101 inhibition remains unclear. Herein we report the case of a lichen planus (LP)\u2010like lesion in presence of anti\u2010BMZ antibodies, preceding BP in a patient treated with pembrolizumab, a PD\u20101 antibody. A 72\u2010year\u2010old Japanese woman with a 3\u2010month history (6 cycles) of pembrolizumab was referred to our department for pruritic purple\u2010red papules or plaques. Histological finding revealed LP\u2010like dermatitis. Although pembrolizumab was stopped because of disease progression, she developed edematous erythematous lesions and tense blisters seven weeks later. Based on histopathological findings, direct immunofluorescence (DIF) assay and positive findings on chemiluminescent enzyme immunoassay (CLEIA) for BP180, she was diagnosed with BP and administered oral prednisolone. The blisters and erythemas improved, whereas her respiratory condition worsened and she died 29\u00a0days after the development of BP. We performed DIF of formalin\u2010fixed, paraffin\u2010embedded specimens biopsied from the LP\u2010like lesion and revealed IgG deposition at the epidermal BMZ. This finding showed anti\u2010BMZ antibodies had already existed at LP\u2010like lesion preceding development of BP; this suggests that the preceding LP\u2010like lesion induced anti\u2010BMZ antibody production, resulting in the development of BP.<\/jats:p>","DOI":"10.1111\/1346-8138.15693","type":"journal-article","created":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T03:45:58Z","timestamp":1605239158000},"page":"401-404","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Lichen planus\u2010like lesion preceding bullous pemphigoid development after programmed cell death protein\u20101 inhibitor treatment"],"prefix":"10.1111","volume":"48","author":[{"given":"Arisa","family":"Sugawara","sequence":"first","affiliation":[{"name":"Department of Dermatology Kurume University School of Medicine Fukuoka Japan"},{"name":"Department of Dermatology St. Mary's Hospital Fukuoka 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