Toxic Epidermal Necrolysis/ Stevens-Johnson Syndrome-like Linear IgA Bullous Dermatosis as a Manifestation of Pembrolizumab

Abstract

Linear IgA bullous dermatosis, also known as linear IgA dermatosis, is a rare subepithelial vesiculobullous disease characterized by linear IgA deposition at the basement membrane zone. Clinically, it presents as tense vesicles or bullae, with histopathology demonstrating subepidermal blistering and a predominantly neutrophilic infiltrate. A linear pattern of IgA deposition at the basement membrane zone via direct immunofluorescence is a hallmark finding for diagnosis. However, this rare autoimmune dermatosis can manifest heterogeneously and non-classically, making histopathological studies critical for accurate diagnosis and subsequent treatment.

In this report, we discuss a rare case of a patient presenting with linear IgA bullous dermatosis exhibiting clinical features similar to Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN), induced by pembrolizumab.