http://pubs.jamanetwork.com/ en-us Wed, 08 May 2013 00:00:00 GMT Wed, 08 May 2013 16:44:10 GMT Silverchair editor@pubs.jamanetwork.com webmaster@pubs.jamanetwork.com http://pubs.jamanetwork.com/article.aspx?articleID=1685912 Wed, 08 May 2013 00:00:00 GMT Sezin T, Egozi E, Hillou W, et al. <span class="paragraphSection"><div class="boxTitle">Importance</div>Bullous pemphigoid (BP) has been previously described to develop after vaccination in 26 patients. Immunoblotting or enzyme-linked immunosorbent assays (ELISAs), which were performed for 7 of these patients, have always shown circulating autoantibodies against BP180 and/or BP230 antigens. A case of anti–laminin-332 mucous membrane pemphigoid (MMP) that developed shortly after a diphtheria tetanus vaccination is described, with a review of the literature on postvaccination BP.<div class="boxTitle">Observations</div>A 29-year-old man developed an acute eruption of oral and cutaneous blisters and erosions 2 days after receiving a diphtheria tetanus vaccination. The histopathological, immunohistochemical, immunofluorescent, ELISA, and immunoblotting assay results were compatible with anti–laminin-332 MMP. The serum autoantibodies reacted with the α3 and β3 subunits of laminin-332. The disease was controlled by administering a combination of glucocorticosteroids and dapsone.<div class="boxTitle">Conclusions and Relevance</div>The development of acute MMP shortly after a diphtheria tetanus vaccination may have been serendipitous, a result of a nonspecific bystander activation of the immune system, or due to structural mimicry between domains of the toxoid molecule and a subunit of laminin-332.</span> 1 5 10.1001/jamadermatol.2013.741 http://pubs.jamanetwork.com/article.aspx?articleID=1685912