A case of pemphigus vulgaris developing after platelet-rich plasma treatment

Platelet-rich plasma (PRP) which is peripheral blood originated product contains high concentrated platelet and many growth factors. It has been used in dermatology for many indications, including alopecias and chronic nonhealing wounds. Pemphigus vulgaris (PV) is a chronic autoimmune bullous disease of the skin and mucous membranes. We report a case of PV induced after the treatment of PRP for female pattern hair loss. The first lesions of PV occurred on the application site of PRP in this case. The diagnosis of mucocutaneous PV was established according to the clinical, cytological, and serological findings. Many physical agents and drugs were reported to induce PV. As far as is known, there is no PRP-related PV case in the literature. An in vitro study demonstrated that PRP may trigger the acantholysis in a genetically susceptible patient and may lead to pemphigus. Virtually, there is no enough evidence showing PRP to cause pemphigus. However, PRP treatment should be performed carefully in such patients.