{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:07:57Z","timestamp":1790798877827,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T00:00:00Z","timestamp":1674518400000},"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":["J Cutan Pathol"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Immune checkpoint inhibitor (ICI)\u2010induced bullous pemphigoid (BP) and Grover disease (GD) are uncommon, and concomitant GD and BP is rarer still. We report a third case of concomitant BP and GD associated with nivolumab with emphasis on the clinical, histopathologic and immunofluorescence findings as well as differential diagnoses. A 73\u2010year\u2010old male with metastatic renal cell carcinoma on nivolumab developed erythematous scaly papules on the trunk with biopsy showing suprabasal acantholysis with dyskeratosis, consistent with GD. Subsequently, he developed widespread lesions on arms, legs, trunk, and scrotum with new vesiculobullae and urticarial lesions. Biopsy of a vesicle showed subepidermal blister with numerous eosinophils and neutrophils, and immunofluorescence and serological studies were supportive of BP. He continued to have clinically apparent GD that was confirmed on repeat biopsy. The patient was diagnosed with concomitant GD and BP induced by nivolumab and successfully treated with dupilumab. The relationship between ICI\u2010induced GD and BP is not well understood; it has been suggested that T\u2010cell activation against the BP180 antigen expressed on surface of tumor cells may predispose susceptible individuals to BP. Subsequent ICI\u2010induced GD may create keratinocyte injury needed to expose additional proteins to reactivated and autoreactive T\u2010cells, leading to autoimmunity. An important differential diagnosis is bullous GD, which can be distinguished by negative immunofluorescence and serological studies.<\/jats:p>","DOI":"10.1111\/cup.14383","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T08:26:11Z","timestamp":1672907171000},"page":"520-523","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Concomitant nivolumab\u2010associated Grover disease and bullous pemphigoid in a patient with metastatic renal cell carcinoma"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8645-4203","authenticated-orcid":false,"given":"Mahyar","family":"Khazaeli","sequence":"first","affiliation":[{"name":"Department of Pathology University at Buffalo  Buffalo New York USA"},{"name":"Department of Pathology and Laboratory Medicine Roswell Park Comprehensive Cancer Center  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raminder","family":"Grover","sequence":"additional","affiliation":[{"name":"Beutner Laboratories  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9267-9484","authenticated-orcid":false,"given":"Susan","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Roswell Park Comprehensive Cancer Center  Buffalo New York USA"},{"name":"Department of Dermatology Roswell Park Comprehensive Cancer Center  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.03.094"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40257\u2010017\u20100336\u20103"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.16068"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e3181c80cf9"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.4065\/74.3.229"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.13312"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.07.008"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.04.105"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2019.09.004"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600\u20100560.2000.027002096.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0190\u20109622(84)70160\u20105"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.13789"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000001756"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.14383","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cup.14383","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.14383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T16:45:51Z","timestamp":1692549951000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.14383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,24]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1111\/cup.14383"],"URL":"https:\/\/doi.org\/10.1111\/cup.14383","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"value":"0303-6987","type":"print"},{"value":"1600-0560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,24]]},"assertion":[{"value":"2022-10-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}