Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review
Abstract
:1. Introduction
2. Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report
3. Bullous Pemphigoid Overlapping Psoriasis Vulgaris: Potential Pathogenic Mechanisms
3.1. Genetic Factors
3.2. Immunological Insights
3.3. Potential Triggers
3.3.1. Viral Infections as Triggers in Disease Development
3.3.2. Psoriasis Vulgaris Medications as Triggers in Disease Development
3.3.3. Non-Psoriasis Medications as Triggers in Disease Development
3.3.4. Rare and Atypical Triggering Factors
4. Bullous Pemphigoid Overlapping Psoriasis Vulgaris: Therapeutic Strategies
4.1. Topical Treatments
4.2. Phototherapy
4.3. Immunosuppresive Systemic Therapy
4.4. Immune-Regulating Therapies
4.5. Biological Treatments
4.6. Targeted Therapies
4.7. Future Approaches
4.8. Combined Therapies
Target | PV | BP | PV and BP (Case Reports) | |
---|---|---|---|---|
LOCAL TREATMENT | ||||
Calcineurin inhibitors | Calcineurin | +[60] | +[60] | - |
Vitamin D3 analogs | Vitamin D receptor | +[60] | - | - |
Corticosteroids | Glucocorticoid receptor | +[60] | +[53,60] | - |
Phototherapy | DNA, T-cells | +[60,77,78,79] | - | - |
PUVA | DNA, T-cells | +[60,79] | - | - |
SYSTEMIC TREATMENTS | ||||
Conventional Systemic Therapies | ||||
Methotrexate | DHFR | +[60,77,78,79,80] | +[53,60] | +[55,75,81,82,83,84,85,86] |
Cyclosporin | Calcineurin | +[60,77,78,79,80] | - | +[87] |
Retinoids—acitretin | Retinoic acid receptors | +[60,77,78,79,80] | - | - |
Corticosteroids | Glucocorticoid receptor | - | +[53,60] | - |
Azathioprine | Purine synthesis | - | +[53] | - |
Mycophenolate mofetil | Inosine monophosphate dehydrogenaze | - | +[53,60] | +[88] |
Fumaric acids | NRF2 pathway | +[77,80] | - | +[22] |
Biologic Therapies | ||||
Anti- TNF-α | ||||
Adalimumab | TNF-α | +[77,78,79,80] | - | - |
Infliximab | TNF-α | +[77,78,79,80] | - | - |
Certolizumab pegol | TNF-α | +[80] | - | - |
Etanercept | TNF-α receptor fusion protein | +[77,78,79,80] | - | +[89,90,91,92] |
Anti IL-12/IL-23 | ||||
Ustekinumab | IL-12 and IL-23, p40 subunit | +[77,78,79,80] | - | +[93] |
Guselkumab | IL-23, p19 subunit | +[80] | - | - |
Tildrakizumab | IL-23, p19 subunit | +[80] | - | - |
Risankizumab | IL-23, p19 subunit | +[80] | - | - |
Anti- IL-17 | ||||
Secukinumab | IL-17 receptor A | +[79,80] | -[64] | +[94,95] |
Ixekizumab | IL-17 receptor A | +[79,80] | - | +[62,96] |
Brodalumab | IL-17 receptor A | +[80] | - | - |
Bimekizumab | IL-17 receptors A, F and AF | |||
Other Biologic Therapies | ||||
Efalizumab | CD11a (LFA-1) | +[77] | - | - |
Alefacept | CD2 | +[77] | - | - |
Omalizumab | IgE | - | +[53,60] | - |
Rituximab | CD20 | - | +[53,60] | - |
Dupilumab | IL-4/IL-30 | - | +[53] | - |
Spesolimab | IL-36 | |||
Targeted therapies | ||||
Tofacitinib | JAK1/JAK3 | - | - | +[70] |
Baricitinib | JAK1/JAK2 | - | - | +[70,97,98] |
Upadacitinib | JAK1 | ? | ? | +[69] |
Apremilast | PDE4 | +[78,79,80] | - | - |
Deucravacitinib | TYK2 | +[99] | - | - |
Others Systemic Therapies | ||||
Dapsone | DHFR | - | +[53,60] | +[22,85] |
Doxycycline | 30S ribosomal subunit | - | +[53] | - |
Immunoglobulins | Broad immune modulation | - | +[53,60] | - |
Immunoadsorption | Autoantibody removal | - | +[53] | - |
5. Conclusions
6. Future Directions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Timofte, M.-A.; Căruntu, C.; Bălăceanu-Gurău, B.; Mărgăritescu, I.; Giurcăneanu, C.; Mihai, M.M. Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review. Clin. Pract. 2025, 15, 91. https://doi.org/10.3390/clinpract15050091
Timofte M-A, Căruntu C, Bălăceanu-Gurău B, Mărgăritescu I, Giurcăneanu C, Mihai MM. Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review. Clinics and Practice. 2025; 15(5):91. https://doi.org/10.3390/clinpract15050091
Chicago/Turabian StyleTimofte, Maria-Alexandra, Constantin Căruntu, Beatrice Bălăceanu-Gurău, Irina Mărgăritescu, Călin Giurcăneanu, and Mara Mădălina Mihai. 2025. "Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review" Clinics and Practice 15, no. 5: 91. https://doi.org/10.3390/clinpract15050091
APA StyleTimofte, M.-A., Căruntu, C., Bălăceanu-Gurău, B., Mărgăritescu, I., Giurcăneanu, C., & Mihai, M. M. (2025). Bullous Pemphigoid Overlapping Psoriasis Vulgaris: A Rare Case Report and Literature Review. Clinics and Practice, 15(5), 91. https://doi.org/10.3390/clinpract15050091