{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T03:47:05Z","timestamp":1792900025645,"version":"4.5.0"},"reference-count":108,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006321","name":"National Institutes of Natural Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitor-induced bullous pemphigoid (ICI-BP) is a rare and complex cutaneous immune-related adverse event (cirAE) that often impacts the continuation of ICI therapy. Currently, there are no prospective clinical studies addressing the optimal management of BP alongside ICI continuation, with existing evidence largely derived from case reports or series. This study systematically analyzes published case reports and series to compile evidence regarding the management of ICI-BP and ICI rechallenge, aiming to inform clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of the PubMed, Embase, and Web of Science Core Collection (WoS CC) databases was conducted from their inception to identify eligible case reports and series. Relevant data were extracted using a standardized form. A total of 116 cases from 89 publications were included in the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was no discernible disparity in the final response rate between patients with mild and severe BP (p &amp;gt; 0.05); however, the percentage of severe patients undergoing escalation therapy was notably higher (p &amp;lt; 0.001). This suggests that employing an active treatment approach based on disease severity effectively ameliorated the potentially graver prognosis in severe cases. Following BP management, 18 patients underwent rechallenge with ICI therapy, with an overall low BP recurrence rate (22.2%), indicating that most patients tolerated the resumption well. Nevertheless, the majority of relapses transpired in patients with initial severe BP, with mucosal invasion, and those who restarted the original therapy, pointing to an elevated risk in this cohort. The 11 deceased patients constituted a high-risk subset distinguished by advanced age (median 74 years), a prevalence of melanoma, and severe BP. The duration from BP diagnosis to demise was briefer in this subset (median 3.7 months), with half of the patients succumbing within 4 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ICI-BP is usually manageable through a stepwise therapeutic approach, and resuming ICI treatment after lesion remission is generally possible. Clinical decision-making must be tailored to the individual patient. Caution and careful monitoring are essential when reinitiating ICI in patients who initially presented with severe disease or mucosal involvement. For elderly patients, those with melanoma, and individuals experiencing severe BP, heightened vigilance is necessary concerning short-term prognostic risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier CRD420251172315\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1745011","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:01:48Z","timestamp":1772607708000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Immune checkpoint inhibitor-induced bullous pemphigoid: a systematic review of clinical characteristics and outcomes based on case reports"],"prefix":"10.3389","volume":"17","author":[{"given":"Lei","family":"Chang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjia","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenping","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqing","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhili","family":"Zhuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(25)00462-0","article-title":"Radiotherapy-free pembrolizumab combined with chemotherapy for locally advanced non-small-cell lung cancer with pd-l1 tumour proportion score of 50% or higher (evolution trial): A multicentre, single-arm, phase 2 study","volume":"26","author":"Hata","year":"2025","journal-title":"Lancet Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2025.1916","article-title":"Nivolumab and ipilimumab combination treatment in advanced ovarian and endometrial clear cell cancers: A nonrandomized clinical trial","volume":"11","author":"Gao","year":"2025","journal-title":"JAMA Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2025.08.035","article-title":"Nivolumab plus ipilimumab for potentially resectable hepatocellular carcinoma: Long-term efficacy and biomarker exploration","volume":"84","author":"Lin","year":"2026","journal-title":"J Hepatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1186\/s12885-025-14733-5","article-title":"Adverse drug events of immune checkpoint inhibitors - a retrospective, descriptive real-world data analysis","volume":"25","author":"Auch","year":"2025","journal-title":"BMC Cancer"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1655724","article-title":"Predictive factors and outcomes of immune-related adverse events in chinese patients treated with immune checkpoint inhibitors: A real-world retrospective study","volume":"16","author":"Kong","year":"2025","journal-title":"Front Immunol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.21836","article-title":"Checkpoint inhibitor-associated bullous cutaneous immune-related adverse events: A multicentre observational study","volume":"187","author":"Kawsar","year":"2022","journal-title":"Br J Dermatol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.07.008","article-title":"Bullous disorders associated with anti-pd-1 and anti-pd-l1 therapy: A retrospective analysis evaluating the clinical and histopathologic features, frequency, and impact on cancer therapy","volume":"79","author":"Siegel","year":"2018","journal-title":"J Am Acad Dermatol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/ijms242316786","article-title":"From molecular insights to clinical perspectives in drug-associated bullous pemphigoid","volume":"24","author":"de Nicolas-Ruanes","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2022.1624","article-title":"Association of bullous pemphigoid with immune checkpoint inhibitor therapy in patients with cancer: A systematic review","volume":"158","author":"Asdourian","year":"2022","journal-title":"JAMA Dermatol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e16169","DOI":"10.7759\/cureus.16169","article-title":"A rare case of bullous pemphigoid secondary to checkpoint inhibitor immunotherapy: A tense situation","volume":"13","author":"Wesolow","year":"2021","journal-title":"Cureus"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1159\/000547431","article-title":"Immune checkpoint inhibitor-induced bullous pemphigoid: Successful treatment with dupilumab while maintaining immunotherapy","volume":"18","author":"Florea","year":"2025","journal-title":"Case Rep Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/cup.12717","article-title":"Autoimmune dermatologic toxicities from immune checkpoint blockade with anti-pd-1 antibody therapy: A report on bullous skin eruptions","volume":"43","author":"Jour","year":"2016","journal-title":"J Cutan Pathol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/cup.13687","article-title":"Neutrophil-predominant bullous pemphigoid induced by checkpoint inhibitors: A case series","volume":"47","author":"Morris","year":"2020","journal-title":"J Cutaneous Pathol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.588582","article-title":"Retrospective analysis of checkpoint inhibitor therapy-associated cases of bullous pemphigoid from six german dermatology centers","volume":"11","author":"Sadik","year":"2020","journal-title":"Front Immunol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2022-253059","article-title":"Two rare cases of bullous pemphigoid associated with immune checkpoint inhibitors","volume":"15","author":"Mazumder","year":"2022","journal-title":"BMJ Case Rep"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2024.11.033","article-title":"Immune checkpoint inhibitor induced bullous pemphigoid treated by dupilumab: A case series","volume":"57","author":"Bogdanski","year":"2025","journal-title":"JAAD Case Rep"},{"key":"B17","article-title":"Bullous pemphigoid associated with a new combination checkpoint inhibitor immunotherapy","volume":"18","author":"Fontecilla","year":"2019","journal-title":"J Drugs Dermatol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1177\/2050313x231160926","article-title":"A case of drug-induced bullous pemphigoid secondary to immunotherapy treated with upadacitinib: A case report","volume":"11","author":"Gresham","year":"2023","journal-title":"SAGE Open Med Case Rep"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2016.2959","article-title":"Immunotherapy-related skin toxicity: Bullous pemphigoid in a lung adenocarcinoma patient treated with the anti-pdl1 antibody atezolizumab","volume":"27","author":"Russo","year":"2017","journal-title":"Eur J Dermatol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.5070\/D32510045817","article-title":"Bullous dermatoses secondary to anti-pd-l1 agents: A case report and review of the literature","volume":"25","author":"Kosche","year":"2019","journal-title":"Dermatol Online J"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1111\/dth.12924","article-title":"A case of atezolizumab-induced photodistributed bullous pemphigoid","volume":"32","author":"Leavitt","year":"2019","journal-title":"Dermatol Ther"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30090566","article-title":"Case report: A presentation of early-onset immune-mediated bullous pemphigoid in a patient with urothelial cancer","volume":"30","author":"Ortega","year":"2023","journal-title":"Curr Oncol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1158\/2326-6066.CIR-15-0123","article-title":"Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting pd-1 and pd-l1","volume":"4","author":"Naidoo","year":"2016","journal-title":"Cancer Immunol Res"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1177\/2054270418793029","article-title":"Bullous pemphigoid associated with ipilimumab therapy for advanced metastatic melanoma","volume":"9","author":"Hanley","year":"2018","journal-title":"JRSM Open"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.14043","article-title":"Bullous pemphigoid induced by ipilimumab in a patient with metastatic Malignant melanoma after unsuccessful treatment with nivolumab","volume":"45","author":"Kuwatsuka","year":"2018","journal-title":"J Dermatol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2021.04.027","article-title":"Bullous pemphigoid secondary to bintrafusp alfa, a bifunctional fusion protein targeting tgf-beta and pd-l1","volume":"13","author":"Wiggins","year":"2021","journal-title":"JAAD Case Rep"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1097\/CMR.0000000000000155","article-title":"A case of bullous pemphigoid in a patient with metastatic melanoma treated with pembrolizumab","volume":"25","author":"Carlos","year":"2015","journal-title":"Melanoma Res"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.12488","article-title":"Late presentation of generalised bullous pemphigoid-like reaction in a patient treated with pembrolizumab for metastatic melanoma","volume":"58","author":"Parakh","year":"2017","journal-title":"Australas J Dermatol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1111\/ced.13042","article-title":"Severe bullous pemphigoid associated with pembrolizumab therapy for metastatic melanoma with complete regression","volume":"42","author":"Rofe","year":"2017","journal-title":"Clin Exp Dermatol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14579","article-title":"Three new cases of bullous pemphigoid during anti-pd-1 antibody therapy","volume":"32","author":"Le Naour","year":"2018","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1159\/000514806","article-title":"A late dermatologic presentation of bullous pemphigoid induced by anti-pd-1 therapy and associated with unexplained neurological disorder","volume":"14","author":"Wang","year":"2021","journal-title":"Case Rep Oncol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14179","article-title":"Two cases of anti-programmed cell death 1-associated bullous pemphigoid-like disease and eruptive keratoacanthomas featuring combined histopathology","volume":"31","author":"Bandino","year":"2017","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.2217\/imt-2019-0027","article-title":"Bullous pemphigoid associated with the 480-mg nivolumab dose in a patient with metastatic renal cell carcinoma","volume":"11","author":"Palla","year":"2019","journal-title":"Immunotherapy"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1111\/cup.14383","article-title":"Concomitant nivolumab-associated grover disease and bullous pemphigoid in a patient with metastatic renal cell carcinoma","volume":"50","author":"Khazaeli","year":"2023","journal-title":"J Cutaneous Pathol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2017.06.004","article-title":"Localized bullous pemphigoid in a melanoma patient with dual exposure to pd-1 checkpoint inhibition and radiation therapy","volume":"3","author":"Hirotsu","year":"2017","journal-title":"JAAD Case Rep"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S374449","article-title":"A case of systemic severe bullous pemphigoid caused by long-term sintilimab treatment for renal cell carcinoma","volume":"15","author":"He","year":"2022","journal-title":"Clin Cosmetic Invest Dermatol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1124730","article-title":"Case report: Bullous pemphigoid associated with sintilimab therapy for pmmr\/mss colorectal cancer","volume":"13","author":"Wang","year":"2023","journal-title":"Front Oncol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"e84911","DOI":"10.7759\/cureus.84911","article-title":"Corticosteroid-refractory bullous pemphigoid due to immune checkpoint inhibitors: A telemedicine challenge","volume":"17","author":"Marco","year":"2025","journal-title":"Cureus"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1177\/2050313X231195462","article-title":"Dupilumab as a treatment for cutaneous immune-related adverse events induced by immune checkpoint inhibitors: A case series and review of the literature","volume":"11","author":"Fournier","year":"2023","journal-title":"SAGE Open Med Case Rep"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2019.02.008","article-title":"Pembrolizumab-induced bullous pemphigoid","volume":"5","author":"Sun","year":"2019","journal-title":"JAAD Case Rep"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1159\/000487127","article-title":"Intensity-modulated radiotherapy triggers onset of bullous pemphigoid in a patient with advanced melanoma treated with nivolumab","volume":"11","author":"Tanita","year":"2018","journal-title":"Case Rep Oncol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.12987","article-title":"Nivolumab-induced bullous pemphigoid after radiotherapy and abscopal effect","volume":"60","author":"Grimaux","year":"2019","journal-title":"Australas J Dermatol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1159\/000514144","article-title":"Refractory bullous pemphigoid in a patient with metastatic lung adenocarcinoma treated with pembrolizumab","volume":"14","author":"Cardona","year":"2021","journal-title":"Case Rep Oncol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000028199","article-title":"Development of bullous pemphigoid following radiation therapy combined with nivolumab for renal cell carcinoma: A case report of abscopal toxicities","volume":"100","author":"Huynh","year":"2021","journal-title":"Med (United States)"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e13030","DOI":"10.1111\/dth.13030","article-title":"Bullous pemphigoid in a patient treated with nivolumab","volume":"32","author":"Cuenca-Barrales","year":"2019","journal-title":"Dermatol Ther"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1068978","article-title":"A case report of steroid-refractory bullous pemphigoid induced by immune checkpoint inhibitor therapy","volume":"13","author":"Guan","year":"2022","journal-title":"Front Immunol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.2147\/ccid.S487711","article-title":"Successful treatment of immune checkpoint inhibitor-induced bullous pemphigoid with omalizumab: A case report and review of the literature","volume":"17","author":"Chen","year":"2024","journal-title":"Clin Cosmetic Invest Dermatol"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000041448","article-title":"Sintilimab-induced photodistributed bullous pemphigoid: A case report","volume":"104","author":"Cui","year":"2025","journal-title":"Medicine"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.5090-24","article-title":"Bullous pemphigoid in patients with non-small-cell lung cancer complicated by diabetes mellitus receiving dipeptidyl peptidase-4 inhibitors and immune checkpoint inhibitors: A case report of two patients and review of literature","volume":"64","author":"Nakashima","year":"2025","journal-title":"Internal Med"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.14742","article-title":"Pruritic bullous skin eruption in a male patient receiving immunotherapy for oropharyngeal cancer","volume":"59","author":"Lee","year":"2020","journal-title":"Int J Dermatol"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2021.4052","article-title":"Dyshidrosiform pemphigoid due to nivolumab therapy","volume":"31","author":"Hayashi","year":"2021","journal-title":"Eur J Dermatol"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1496413","article-title":"Case report: Low-dose interleukin-2: A treatment of bullous pemphigoid with predominantly perifollicular blistering caused by pd-1\/pd-l1 inhibitor","volume":"15","author":"Zhang","year":"2024","journal-title":"Front Immunol"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0128","article-title":"A case of nivolumab-induced bullous pemphigoid: Review of dermatologic toxicity associated with programmed cell death protein-1\/programmed death ligand-1 inhibitors and recommendations for diagnosis and management","volume":"23","author":"Lopez","year":"2018","journal-title":"Oncologist"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1111\/cup.14183","article-title":"Nivolumab-induced localized genital bullous pemphigoid in a 60-year-old male","volume":"49","author":"Alvarado","year":"2022","journal-title":"J Cutan Pathol"},{"key":"B55","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.jdcr.2024.12.014","article-title":"Severe case of bullous pemphigoid associated with nivolumab responsive to combination therapy with dupilumab and omalizumab","volume":"57","author":"Victory","year":"2025","journal-title":"JAAD Case Rep"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.2217\/imt-2022-0113","article-title":"Cutaneous metastases at the sites of pembrolizumab-induced bullous pemphigoid lesions in a patient with melanoma","volume":"14","author":"V\u00e1nyai","year":"2022","journal-title":"Immunotherapy"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2016.05.009","article-title":"Development of bullous pemphigoid during nivolumab therapy","volume":"2","author":"Damsky","year":"2016","journal-title":"JAAD Case Rep"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2017.0091","article-title":"Rituximab treatment of nivolumab-induced bullous pemphigoid","volume":"153","author":"Sowerby","year":"2017","journal-title":"JAMA Dermatol"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2020.01.008","article-title":"Bullous pemphigoid associated with cemiplimab therapy in a patient with locally advanced cutaneous squamous cell carcinoma","volume":"6","author":"Virgen","year":"2020","journal-title":"JAAD Case Rep"},{"key":"B60","doi-asserted-by":"publisher","first-page":"E21","DOI":"10.12788\/cutis.1058","article-title":"Cyclosporine for recalcitrant bullous pemphigoid induced by nivolumab therapy for Malignant melanoma","volume":"114","author":"Wallace","year":"2024","journal-title":"Cutis"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.5070\/D328257396","article-title":"A case of nivolumab-induced bullous pemphigoid successfully treated with dupilumab","volume":"28","author":"Bruni","year":"2022","journal-title":"Dermatol Online J"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31743","article-title":"Pembrolizumab-associated bullous pemphigoid with laryngeal involvement","volume":"135","author":"Triantafillou","year":"2025","journal-title":"Laryngoscope"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2024-263285","article-title":"Remote presentation of nivolumab-induced bullous pemphigoid in hepatocellular carcinoma","volume":"18","author":"Yoo","year":"2025","journal-title":"BMJ Case Rep"},{"key":"B64","doi-asserted-by":"publisher","first-page":"e24804","DOI":"10.7759\/cureus.24804","article-title":"A case of bullous pemphigoid associated with nivolumab therapy","volume":"14","author":"Gotera","year":"2022","journal-title":"Cureus"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.984132","article-title":"Durable disease control and refractory bullous pemphigoid after immune checkpoint inhibitor discontinuation in metastatic renal cell carcinoma: A case report","volume":"13","author":"Mari","year":"2022","journal-title":"Front Immunol"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01934","article-title":"Checkpoint inhibition may trigger the rare variant of anti-lad-1 igg-positive, anti-bp180 nc16a igg-negative bullous pemphigoid","volume":"10","author":"Sadik","year":"2019","journal-title":"Front Immunol"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.5070\/d327955136","article-title":"Dupilumab for the treatment of nivolumab-induced bullous pemphigoid: A case report and review of the literature","volume":"27","author":"Klepper","year":"2021","journal-title":"Dermatol Online J"},{"key":"B68","doi-asserted-by":"publisher","first-page":"e15623","DOI":"10.1111\/dth.15623","article-title":"Dupilumab for the treatment of pembrolizumab-induced bullous pemphigoid: A case report","volume":"35","author":"Pop","year":"2022","journal-title":"Dermatol Ther"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2024.09.019","article-title":"Treatment of immune checkpoint inhibitor-induced bullous pemphigoid with methotrexate","volume":"54","author":"Myers","year":"2024","journal-title":"JAAD Case Rep"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1613552","article-title":"Case report: Dupilumab therapy for immune checkpoint inhibitor-induced bullous pemphigoid enables dual immunotherapy initiation in progressive Malignant melanoma","volume":"15","author":"Gr\u00fcninger","year":"2025","journal-title":"Front Oncol"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2020.07.027","article-title":"Immune checkpoint inhibitor-induced bullous pemphigoid: Towards a new class of drug-drug interaction","volume":"138","author":"Pujalte-Martin","year":"2020","journal-title":"Eur J Cancer"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2020.03.003","article-title":"Bullous pemphigoid secondary to pembrolizumab mimicking toxic epidermal necrolysis","volume":"6","author":"Qiu","year":"2020","journal-title":"JAAD Case Rep"},{"key":"B73","doi-asserted-by":"publisher","first-page":"e21770","DOI":"10.7759\/cureus.21770","article-title":"Bullous pemphigoid associated with pembrolizumab therapy for non-small-cell lung cancer: A case report","volume":"14","author":"Chatterjee","year":"2022","journal-title":"Cureus"},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2019.3618","article-title":"Detection of igg antibodies to bp180 nc16a and c-terminal domains and lad-1 in nivolumab-associated bullous pemphigoid","volume":"29","author":"Matsui","year":"2019","journal-title":"Eur J Dermatol"},{"key":"B75","doi-asserted-by":"publisher","first-page":"e15948","DOI":"10.1111\/dth.15948","article-title":"Intravenous immunoglobulin for pembrolizumab-induced bullous pemphigoid-like eruption: A case report","volume":"35","author":"Hoshina","year":"2022","journal-title":"Dermatol Ther"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.1093\/skinhd\/vzae023","article-title":"A case of pembrolizumab-induced bullous pemphigoid treated with dupilumab","volume":"5","author":"Rossi","year":"2025","journal-title":"Skin Health Dis"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13970","article-title":"Novel use of combination therapeutic plasma exchange and rituximab in the treatment of nivolumab-induced bullous pemphigoid","volume":"57","author":"Ridpath","year":"2018","journal-title":"Int J Dermatol"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14143","article-title":"Bullous pemphigoid associated with nivolumab, a programmed cell death 1 protein inhibitor","volume":"31","author":"Kwon","year":"2017","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B79","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2019.3619","article-title":"Nivolumab-associated bullous pemphigoid reactions involving multiple epitopes","volume":"29","author":"Aoki","year":"2019","journal-title":"Eur J Dermatol"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.4103\/ijd.IJD_321_18","article-title":"Nivolumab-induced bullous pemphigoid managed without drug withdrawal","volume":"65","author":"Munera-Campos","year":"2020","journal-title":"Indian J Dermatol"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.1016\/j.abd.2023.07.018","article-title":"Association of bullous pemphigoid and grover disease induced by immune checkpoint therapy","volume":"99","author":"Pinto-Pulido","year":"2024","journal-title":"Bras Dermatol"},{"key":"B82","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.14813","article-title":"Severe bullous pemphigoid in a metastatic lung cancer patient treated with pembrolizumab","volume":"46","author":"Adachi","year":"2019","journal-title":"J Dermatol"},{"key":"B83","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.2090","article-title":"Pembrolizumab-induced sarcoid granulomatous panniculitis and bullous pemphigoid in a single patient","volume":"7","author":"Honigman","year":"2019","journal-title":"Clin Case Rep"},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.1111\/cup.12735","article-title":"Cutaneous autoimmune effects in the setting of therapeutic immune checkpoint inhibition for metastatic melanoma","volume":"43","author":"Mochel","year":"2016","journal-title":"J Cutan Pathol"},{"key":"B85","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.13940","article-title":"Bullous pemphigoid induced by pembrolizumab in a patient with advanced melanoma expressing collagen xvii","volume":"44","author":"Wada","year":"2017","journal-title":"J Dermatol"},{"key":"B86","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.1111\/1346-8138.15140","article-title":"Bullous pemphigoid induced by pembrolizumab in a patient with non-small-cell lung cancer who achieved durable complete response despite treatment cessation and long-term corticosteroid administration: A case report","volume":"47","author":"Muto","year":"2020","journal-title":"J Dermatol"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.731774","article-title":"Case report: A rare case of pembrolizumab-induced bullous pemphigoid","volume":"12","author":"Zhang","year":"2021","journal-title":"Front Immunol"},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.13411","article-title":"Localized pretibial bullous pemphigoid arising in a patient on pembrolizumab for metastatic melanoma","volume":"16","author":"Amber","year":"2018","journal-title":"J Dtsch Dermatol Ges"},{"key":"B89","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.08.022","article-title":"Bullous pemphigoid and nivolumab: Dermatologic management to support and continue oncologic therapy","volume":"103","author":"Panariello","year":"2018","journal-title":"Eur J Cancer"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14171958","article-title":"A case of bullous pemphigoid with significant infiltration of cd4-positive t cells during treatment with pembrolizumab, accompanied by pembrolizumab-induced multi-organ dysfunction","volume":"14","author":"Mima","year":"2024","journal-title":"Diagnostics"},{"key":"B91","doi-asserted-by":"publisher","DOI":"10.1097\/cmr.0000000000000260","article-title":"Bullous pemphigoid, an autoantibody-mediated disease, is a novel immune-related adverse event in patients treated with anti-programmed cell death 1 antibodies","volume":"26","author":"Hwang","year":"2016","journal-title":"Melanoma Res"},{"key":"B92","doi-asserted-by":"publisher","DOI":"10.1159\/000489661","article-title":"Bullous pemphigoid as an adverse reaction to pembrolizumab: Two case reports","volume":"10","author":"Thomsen","year":"2018","journal-title":"Case Rep Dermatol"},{"key":"B93","doi-asserted-by":"publisher","DOI":"10.1177\/1078155220946370","article-title":"Bullous pemphigoid in elderly woman affected by non-small cell lung cancer treated with pembrolizumab: A case report and review of literature","volume":"27","author":"Cosimati","year":"2021","journal-title":"J Oncol Pharm Pract"},{"key":"B94","doi-asserted-by":"publisher","DOI":"10.1097\/rlu.0000000000003894","article-title":"Immunotherapy (cemiplimab)-induced bullous pemphigoid: A possible pitfall in 18f-fdg pet\/ct","volume":"47","author":"Gr\u00fcnig","year":"2022","journal-title":"Clin Nucl Med"},{"key":"B95","doi-asserted-by":"publisher","DOI":"10.1111\/ced.15177","article-title":"The iso-oncotopic response: Immunotherapy-associated bullous pemphigoid in tumour footprints","volume":"47","author":"Pearlman","year":"2022","journal-title":"Clin Exp Dermatol"},{"key":"B96","doi-asserted-by":"publisher","first-page":"e43230","DOI":"10.7759\/cureus.43230","article-title":"Delayed onset of bullous pemphigoid secondary to nivolumab","volume":"15","author":"Olsen","year":"2023","journal-title":"Cureus"},{"key":"B97","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijwd.2020.09.001","article-title":"Bullous pemphigoid in a metastatic lung cancer patient associated with nivolumab","volume":"6","author":"Maya","year":"2020","journal-title":"Int J Womens Dermatol"},{"key":"B98","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.15796","article-title":"Bullous pemphigoid probably associated with pembrolizumab: A case of delayed toxicity","volume":"61","author":"Correia","year":"2022","journal-title":"Int J Dermatol"},{"key":"B99","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.17517","article-title":"Immune checkpoint inhibitor-associated bullous pemphigoid: A retrospective and real-world study based on the United States food and drug administration adverse event reporting system","volume":"52","author":"Tan","year":"2025","journal-title":"J Dermatol"},{"key":"B100","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2012.11108.x","article-title":"Clinical presentation and diagnostic delay in bullous pemphigoid: A prospective nationwide cohort","volume":"167","author":"della Torre","year":"2012","journal-title":"Br J Dermatol"},{"key":"B101","doi-asserted-by":"publisher","first-page":"e70093","DOI":"10.1111\/imr.70093","article-title":"Hypertension as an immune disorder: From cellular drivers to molecular mediators","volume":"337","author":"Hunter","year":"2026","journal-title":"Immunol Rev"},{"key":"B102","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.it.2025.02.014","article-title":"Diabetes can impact cellular immunity in solid tumors","volume":"46","author":"Garstka","year":"2025","journal-title":"Trends Immunol"},{"key":"B103","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.freeradbiomed.2025.12.041","article-title":"Oxidative stress impairs the expansion of regulatory t cells in active vitiligo via dysregulated cgrp-ramp1-g\u03b1i3 signaling","volume":"245","author":"Zhang","year":"2025","journal-title":"Free Radic Biol Med"},{"key":"B104","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2025.2586216","article-title":"Role of interleukin 17 and t helper cells 17 cells as a new immune target and signalling in the pathogenesis and treatment of autoimmune thyroid diseases","volume":"57","author":"He","year":"2025","journal-title":"Ann Med"},{"key":"B105","doi-asserted-by":"publisher","DOI":"10.3390\/cells14242002","article-title":"B cells can trigger the t-cell-mediated autoimmune response against melanocytes in psoriasis","volume":"14","author":"He","year":"2025","journal-title":"Cells"},{"key":"B106","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002292.pub4","article-title":"Interventions for bullous pemphigoid","volume":"8","author":"Singh","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"B107","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1613552","article-title":"Case report: Dupilumab therapy for immune checkpoint inhibitor-induced bullous pemphigoid enables dual immunotherapy initiation in progressive Malignant melanoma","volume":"15","author":"Gr\u00fcninger","year":"2025","journal-title":"Front Oncol"},{"key":"B108","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.17044","article-title":"Bullous pemphigoid exacerbated by nivolumab and temporally rescued with therapeutic plasma exchange","volume":"51","author":"Waki","year":"2024","journal-title":"J Dermatol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1745011\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:01:51Z","timestamp":1772607711000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1745011\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,4]]},"references-count":108,"alternative-id":["10.3389\/fimmu.2026.1745011"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1745011","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,4]]},"article-number":"1745011"}}