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Case Reports
. 2024 Sep 28:53:132-135.
doi: 10.1016/j.jdcr.2024.08.046. eCollection 2024 Nov.

The use of ibrutinib for the management of paraneoplastic bullous pemphigoid associated with monoclonal B-lymphocytosis: A case report and brief literature review

Vy X Pham  1 , Aleksandr Itkin  2 , Marin F Xavier  3 , Erik Gilbertson  2
Affiliations
Case Reports

The use of ibrutinib for the management of paraneoplastic bullous pemphigoid associated with monoclonal B-lymphocytosis: A case report and brief literature review

Vy X Pham et al. JAAD Case Rep. .
No abstract available

Keywords: CLL; MBL; autoimmune; bullous pemphigoid; chronic lymphocytic leukemia; ibrutinib; lymphoproliferative; monoclonal B-lymphocytosis; paraneoplastic; pemphigus.

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Conflict of interest statement

Dr Xavier has consulted, advised, and served on the speaker’s bureau for Imbruvica (Ibrutinib) for which she received consultant fees and honoraria, but not in the last 12 months. Author Pham and Drs Itkin and Gilbertson have no conflict of interests to disclose.

Figures

Fig 1
Fig 1
Lesions before ibrutinib. These series of clinical images are a chronological (2019 (A), 2020 (B), 2021 (C), 2022 (D)) documentation of the persistent, diffuse bullous lesions of the trunk and extremities, resistant to the multiple trialed therapies.
Fig 2
Fig 2
Biopsies stained with hematoxylin and eosin (H&E) stain from 2019 (A and B) at 20× and 100× magnification, respectively and 2020 (C and D) at 40× and 100× magnification, respectively, demonstrating acantholysis of the skin, resulting in blister formation.
Fig 3
Fig 3
Lesions after ibrutinib. The clinical images in panels (A) and (B) demonstrate drastically reduced blister formation after 1 month of high dose ibrutinib. The clinical images in panels (C) and (D) are from a follow-up appointment after the patient developed venous stasis dermatitis 3 months after starting ibrutinib and a few weeks after being restarted on a reduced dose, demonstrating patchy scaling, but no blister formation.
See this image and copyright information in PMC

References

    1. Zhao L., Wang Q., Liang G., et al. Evaluation of dupilumab in patients with bullous pemphigoid. JAMA Dermatol. 2023;159(9):953–960. doi: 10.1001/jamadermatol.2023.2428. - DOI - PMC - PubMed
    1. Rawstron A.C., Bennett F.L., O'Connor S.J., et al. Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia. N Engl J Med. 2008;359(6):575–583. doi: 10.1056/NEJMoa075290. - DOI - PubMed
    1. Chen C., Xu Y., Yu J., Qian S., Xie Y. A first case of successful using of ibrutinib in treating paraneoplastic pemphigus related bronchiolitis obliterans concurrent with CLL. Front Med (Lausanne) 2023;10 doi: 10.3389/fmed.2023.1132535. - DOI - PMC - PubMed
    1. Freund J., Trautinger F., Kopetzky G., Prillinger K. Obinutuzumab in a patient with chronic lymphocytic leukemia-associated paraneoplastic pemphigus. JAAD Case Rep. 2022;27:114–116. doi: 10.1016/j.jdcr.2022.07.011. - DOI - PMC - PubMed
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