Dermatitis Herpetiformis Associated with Celiac Disease Exacerbated by Enfortumab Vedotin-ejfv and Pembrolizumab

Dermatitis herpetiformis (DH) is a cutaneous autoimmune eruption most commonly associated with celiac disease. DH has also been linked to medications including gonadotropin-releasing hormone analogs, tumor necrosis factor-alpha inhibitors, and nonsteroidal anti-inflammatory drugs. We report a novel case of DH induced by the immunotherapies: enfortumab and pembrolizumab, not previously described in the literature. The underlying cause of our patient’s DH was difficult to determine as he was treated with both pembrolizumab and enfortumab immunotherapies while having newly diagnosed celiac disease. Our patient responded well to dapsone initiated 1 week before and continuing 1 week after receiving the immunotherapy infusions.