{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T23:05:38Z","timestamp":1774566338531,"version":"3.50.1"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Autoimmune blistering diseases (AIBDs) are mediated by autoantibodies targeting structural proteins of the epidermis or dermo-epidermal junction. Since the introduction of COVID-19 mRNA vaccines, isolated cases of pemphigus temporally associated with vaccination have been described, although causal relationships remain uncertain. We report two patients who developed pemphigus following COVID-19 mRNA vaccination and showed an exceptionally favorable clinical course. A 66-year-old man developed pemphigus foliaceus one week after his second vaccine dose, and a 45-year-old woman developed pemphigus vulgaris two months after her second dose. Both patients responded promptly to corticosteroid therapy, with normalization of autoantibody titers and achievement of long-term complete remission lasting over two years without relapse or maintenance therapy. These outcomes stand in contrast to sporadic pemphigus, which usually follows a chronic relapsing course, and suggest that vaccine-related pemphigus may, in rare instances, represent a transient and self-limited immune dysregulation. Such cases are exceptional and should not discourage COVID-19 vaccination.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1721035","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T06:47:29Z","timestamp":1770706049000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Pemphigus following COVID-19 mRNA vaccination: two cases achieving long-term remission without relapse"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuri","family":"Fukunaga","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natsuko","family":"Saito-Sasaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eri","family":"Ohta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Sawada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-03739-1","article-title":"Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2","volume":"596","author":"Collier","year":"2021","journal-title":"Nature"},{"key":"B3","doi-asserted-by":"publisher","first-page":"103340","DOI":"10.1016\/j.autrev.2023.103340","article-title":"Insights into new-onset autoimmune diseases after COVID-19 vaccination","volume":"22","author":"Guo","year":"2023","journal-title":"Autoimmun Rev"},{"key":"B4","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1038\/s41572-025-00595-5","article-title":"Bullous pemphigoid","volume":"11","author":"Akbarialiabad","year":"2025","journal-title":"Nat Rev Dis Primers"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2021.06.026","article-title":"Subepidermal blistering eruptions, including bullous pemphigoid, following COVID-19 vaccination","volume":"148","author":"Tomayko","year":"2021","journal-title":"J Allergy Clin Immunol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.09.002","article-title":"Clinical and pathologic correlation of cutaneous COVID-19 vaccine reactions including V-REPP: A registry-based study","volume":"86","author":"McMahon","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1126\/science.abd2321","article-title":"Structural basis of a shared antibody response to SARS-CoV-2","volume":"369","author":"Yuan","year":"2020","journal-title":"Science"},{"key":"B8","doi-asserted-by":"publisher","first-page":"57","DOI":"10.5483\/BMBRep.2022.55.2.183","article-title":"Emerging role of bystander T cell activation in autoimmune diseases","volume":"55","author":"Shim","year":"2022","journal-title":"BMB Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1896","DOI":"10.3390\/v16121896","article-title":"Pemphigus and bullous pemphigoid following COVID-19 vaccination: A systematic review","volume":"16","author":"Martora","year":"2024","journal-title":"Viruses"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1721035\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T06:47:30Z","timestamp":1770706050000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1721035\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":9,"alternative-id":["10.3389\/fimmu.2026.1721035"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1721035","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]},"article-number":"1721035"}}