依沃西单抗注射液引起的大疱性类天疱疮一例

A Case of Bullous Pemphigoid Induced by Ivonescimab Injection

摘要: 大疱性类天疱疮(BP)是一种以老年患者为主的自身免疫性大疱性皮肤病，其发病机制与针对基底膜带的自身抗体密切相关。本文报告一例由依沃西单抗注射液诱发的药物相关性BP。患者为63岁男性，确诊直肠癌伴肺转移，在接受依沃西单抗治疗10天后，四肢、躯干及颈部逐渐出现红斑、水疱及大疱性皮损。组织病理学检查可见表皮内大疱形成，疱腔内伴有嗜酸性粒细胞浸润；直接免疫荧光检测显示基底膜带IgG和C3呈线状沉积。经系统性糖皮质激素治疗后，患者皮损显著改善。本病例提示，依沃西单抗可能存在诱发大疱性类天疱疮的风险，临床应用中应密切关注其皮肤不良反应。

Abstract: Bullous Pemphigoid (BP) is an autoimmune blistering dermatosis predominantly affecting elderly patients, with its pathogenesis closely associated with autoantibodies targeting the basement membrane zone. This report describes a case of drug-induced BP triggered by ivonescimab injection. The patient was a 63-year-old male diagnosed with rectal cancer and lung metastasis. Ten days after initiating ivonescimab therapy, he developed progressive erythema, vesicles, and bullae on the extremities, trunk, and neck. Histopathological examination revealed intraepidermal blister formation with eosinophilic infiltration within the blister cavity. Direct immunofluorescence demonstrated linear deposition of IgG and C3 along the basement membrane zone. The patient’s skin lesions improved significantly following systemic corticosteroid treatment. This case suggests that ivonescimab may pose a risk for inducing bullous pemphigoid, and clinicians should remain vigilant for cutaneous adverse reactions during its clinical application.