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Khan M, Park L, Skopit S. Management Options for Linear Immunoglobulin A (IgA) Bullous Dermatosis: A Literature Review. Cureus 2023; 15:e36481. [PMID: 37090290 PMCID: PMC10115698 DOI: 10.7759/cureus.36481] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 03/16/2023] [Indexed: 04/25/2023] Open
Abstract
Linear immunoglobulin A (IgA) bullous dermatosis (LABD) is an autoimmune condition with various triggers. Because of the lack of randomized controlled trials on LABD treatment, management options are mostly anecdotal. This paper provides a comprehensive review of treatment options from a literature review of reported treatments to arm clinicians with a guideline for the management of LABD in both pediatric and adult patients as well as those recalcitrant to first-line therapy (dapsone and steroids). We additionally illustrate an algorithm to use for the management of LABD to aid clinicians when faced with unique patient circumstances.
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Affiliation(s)
- Madiha Khan
- Department of Dermatology, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Lily Park
- Department of Dermatology, Larkin Community Hospital, Miami, USA
- Department of Dermatology, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University (NSU) Florida, Fort Lauderdale, USA
| | - Stanley Skopit
- Department of Dermatology, Larkin Community Hospital, Miami, USA
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Abstract
Although relatively uncommon, autoimmune bullous diseases carry the risk of increased mortality and can significantly impact quality of life. This group of diseases is broad and encompasses subepidermal conditions like bullous pemphigoid, cicatricial pemphigoid, epidermolysis bullosa acquisita, dermatitis herpetiformis, and linear IgA bullous dermatosis, as well as intraepidermal conditions like pemphigus and its variants. The pathophysiology of each condition is incompletely understood but broadly involves the formation of autoantibodies targeting skin adhesion proteins, a process which relies on a complex interplay between a dysregulated immune system, genetic predisposition, and environmental factors. We review the impact of nutrition on pathogenesis, clinical course, and treatment of various autoimmune bullous diseases.
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di Cerbo A, Pezzuto F, Guidetti G, Canello S, Corsi L. Tetracyclines: Insights and Updates of their Use in Human and Animal Pathology and their Potential Toxicity. Open Biochem J 2019. [DOI: 10.2174/1874091x01913010001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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4
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Forbat E, Al-Niaimi F, Ali FR. Use of nicotinamide in dermatology. Clin Exp Dermatol 2017; 42:137-144. [PMID: 28052374 DOI: 10.1111/ced.13021] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2016] [Indexed: 02/04/2023]
Abstract
Nicotinamide (niacinamide) is the water-soluble, amide form of vitamin B3. We review the evidence underlying the use of nicotinamide for various dermatological indications, including nonmelanoma cancer prophylaxis, blistering disorders, acne vulgaris and cosmetic indications, and speculate upon its future role in dermatological practice.
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Affiliation(s)
- E Forbat
- King Edward VII Hospital, London, UK
| | - F Al-Niaimi
- Dermatological Surgery and Laser Unit, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - F R Ali
- Dermatological Surgery and Laser Unit, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
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Cui YX, Yang BQ, Zhou GZ, Zhang FR. Childhood linear IgA bullous dermatosis successfully treated with oral nicotinamide. Clin Exp Dermatol 2016; 41:816-8. [PMID: 27663162 DOI: 10.1111/ced.12892] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Y X Cui
- Shandong Clinical College of Skin Diseases, Anhui Medical University, Jinan, PR, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Provincial Academy of Medical Science, Jinan, PR, China.,Shandong Provincial Hospital for Skin Diseases, Jinan, PR, China.,Department of Dermatology, People's Hospital of Shouguang, Weifang, PR, China
| | - B Q Yang
- Shandong Clinical College of Skin Diseases, Anhui Medical University, Jinan, PR, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Provincial Academy of Medical Science, Jinan, PR, China.,Shandong Provincial Hospital for Skin Diseases, Jinan, PR, China
| | - G Z Zhou
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Provincial Academy of Medical Science, Jinan, PR, China.,Shandong Provincial Hospital for Skin Diseases, Jinan, PR, China
| | - F R Zhang
- Shandong Clinical College of Skin Diseases, Anhui Medical University, Jinan, PR, China. .,Shandong Provincial Institute of Dermatology and Venereology, Shandong Provincial Academy of Medical Science, Jinan, PR, China. .,Shandong Provincial Hospital for Skin Diseases, Jinan, PR, China.
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6
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Fukuda A, Himejima A, Tsuruta D, Koga H, Ohyama B, Morita S, Hashimoto T. Four cases of mucous membrane pemphigoid with clinical features of oral lichen planus. Int J Dermatol 2016; 55:657-65. [PMID: 26341508 DOI: 10.1111/ijd.12884] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 08/27/2014] [Accepted: 10/19/2014] [Indexed: 01/25/2023]
Abstract
BACKGROUND Mucous membrane pemphigoid (MMP) and oral lichen planus (OLP) show similar clinical features on the oral mucosa. As clinical manifestations of oral mucosal lesions, MMP shows blisters and erosions, whereas OLP shows lace-like whitish lesions in an annular arrangement with erythema and erosions. Histopathologically, MMP shows subepithelial bullae with infiltrates of lymphocytes and neutrophils, whereas OLP shows band-like interface infiltration of lymphocytes with damage in basal cells. However, these two diseases are frequently difficult to distinguish both clinically and histopathologically. OBJECTIVES We report four patients with oral MMP who showed OLP-like clinical and histopathological lesions. METHODS We performed direct immunofluorescence, indirect immunofluorescence of normal human skin and 1 m NaCl-split skin, enzyme-linked immunosorbent assays for BP180, BP230, and desmogleins 1 and 3, and immunoblotting of normal human epidermal and dermal extracts, recombinant proteins of BP180-NC16a and -C-terminal domains, concentrated culture supernatant of HaCaT cells, and purified laminin-332. RESULTS The results of various immunological studies suggested the diagnoses of various types of MMP for all four patients. CONCLUSIONS Because MMP and OLP require different treatments, all dentists and dermatologists should have knowledge about the disease entity and the serological diagnostic methods for various types of MMP.
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Affiliation(s)
- Aoi Fukuda
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan
| | - Akio Himejima
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
- Department of Dermatology, Kurume University School of Medicine , Fukuoka, Japan
- Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine , Fukuoka, Japan
- Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - Bungo Ohyama
- Department of Dermatology, Kurume University School of Medicine , Fukuoka, Japan
- Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - Shosuke Morita
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Kurume University School of Medicine , Fukuoka, Japan
- Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
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Wozniak K, Hashimoto T, Ishii N, Koga H, Huczek M, Kowalewski C. Fluorescence overlay antigen mapping using laser scanning confocal microscopy differentiates linear IgA bullous dermatosis from epidermolysis bullosa acquisita mediated by IgA. Br J Dermatol 2013; 168:634-8. [DOI: 10.1111/bjd.12017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sapadin AN, Fleischmajer R. Tetracyclines: nonantibiotic properties and their clinical implications. J Am Acad Dermatol 2006; 54:258-65. [PMID: 16443056 DOI: 10.1016/j.jaad.2005.10.004] [Citation(s) in RCA: 463] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2004] [Revised: 08/16/2005] [Accepted: 10/05/2005] [Indexed: 10/25/2022]
Abstract
Tetracyclines are broad-spectrum antibiotics that act as such at the ribosomal level where they interfere with protein synthesis. They were first widely prescribed by dermatologists in the early 1950s when it was discovered that they were effective as a treatment for acne. More recently, biologic actions affecting inflammation, proteolysis, angiogenesis, apoptosis, metal chelation, ionophoresis, and bone metabolism have been researched. The therapeutic effects of tetracycline and its analogues in various diseases have also been investigated. These include rosacea, bullous dermatoses, neutrophilic diseases, pyoderma gangrenosum, sarcoidosis, aortic aneurysms, cancer metastasis, periodontitis, and autoimmune disorders such as rheumatoid arthritis and scleroderma. We review the nonantibiotic properties of tetracycline and its analogues and their potential for clinical application.
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Affiliation(s)
- Allen N Sapadin
- Department of Dermatology, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
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Mutasim DF. Management of autoimmune bullous diseases: Pharmacology and therapeutics. J Am Acad Dermatol 2004; 51:859-77; quiz 878-80. [PMID: 15583576 DOI: 10.1016/j.jaad.2004.02.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Bullous diseases are associated with high morbidity and mortality. They result from autoimmune response to one or more components of the basement membrane or desmosomes. Management consists of treating the immunologic basis of the disease, treating the inflammatory process involved in lesion formation, and providing supportive care both locally and systemically. Therapeutic agents are chosen based on their known pharmacologic properties and evidence of effectiveness derived from observations and studies. Learning objectives At the completion of this learning activity, participants should be able to understand the pharmacology of drugs used in the treatment of bullous diseases, the principles of therapy for various such diseases, and a practical approach to the management of these diseases.
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Affiliation(s)
- Diya F Mutasim
- Department of Dermatology, University of Cincinnati, College of Medicine, OH 45267-0592, USA.
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Wolf R, Orion E, Matz H, Tüzün Y, Tüzün B. Miscellaneous treatments, II: niacin and heparin: unapproved uses, dosages, or indications. Clin Dermatol 2002; 20:547-57. [PMID: 12435525 DOI: 10.1016/s0738-081x(02)00268-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Ronni Wolf
- Dermatology Unit, Kaplan Medical Center, Rechovot, Israel.
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Affiliation(s)
- G C Chaidemenos
- Hospital For Skin and Venereal Diseases, Department of Dermatology and Venereology, Thessaloniki, Greece.
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