Introduction

Programmed death-1 (PD-1) inhibitors are a class of immune checkpoint inhibitors (ICIs) that allow unchecked activity of cell-mediated immunity against tumor cells [1]. They have been used as targeted treatments for various malignancies, including melanoma, non-small cell lung carcinoma (NSCLC), and cutaneous squamous cell carcinoma. The use of immune checkpoint inhibitors can lead to loss of peripheral tolerance, resulting in a constellation of immune-related adverse events (irAEs). Organ systems primarily affected by the ICIs include the skin, gastrointestinal tract, liver, lungs, and endocrine glands [2]. They can occur in up to 60% of patients on monotherapy with ICI, with 14% of these being high-grade irAEs [2]. Cutaneous irAEs are the most common among these adverse events, including rash, pruritus, and vitiligo [3]. According to a single-center retrospective study, bullous autoimmune conditions associated with ICI occur in approximately 1% of cases and include bullous pemphigoid, linear IgA bullous dermatosis (LABD), and bullous lichenoid dermatitis [4]. LABD is a rare autoimmune blistering condition that involves the skin's basement membrane. It is characterized by subepidermal tense bullae with a distribution pattern that varies with age [5,6]. We describe a case of LABD in a patient after the use of pembrolizumab for non-small-cell adenocarcinoma of the lung.