Childhood Epidermolysis Bullosa Acquisita During Squaric Acid Dibutyl Ester Immunotherapy for Alopecia Areata

May 2016 in “ British Journal of Dermatology ”

Liliana Guerra, Valeria Pacifico, Valentina Calabresi, Naomi De Luca, Daniele Castiglia, Chiara D’Angelo, Giovanna Zambruno, Giovanni Di Zenzo

epidermolysis bullosa acquisita squaric acid dibutyl ester alopecia areata immunotherapy steroid therapy dapsone therapy EBA SADBE

TLDR A 6-year-old boy's skin condition improved after stopping a specific treatment and starting new medications.

A 6-year-old boy developed the inflammatory variant of epidermolysis bullosa acquisita (EBA) shortly after starting immunotherapy with squaric acid dibutyl ester (SADBE) for scalp alopecia areata. The EBA symptoms rapidly regressed after discontinuing SADBE and initiating combined steroid and dapsone therapy, with no recurrence after treatment tapering and withdrawal. This case suggested a possible role of SADBE in triggering EBA, marking the first reported instance of EBA occurring during alopecia areata treatment.

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