1
|
Garg P, Lakhey K, Mishra N, Buccha Y, Deo KS. Navigating Treatment Dilemmas: Recalcitrant Pemphigus and the Burden of Multiple Comorbidities. Cureus 2024; 16:e56357. [PMID: 38633948 PMCID: PMC11022114 DOI: 10.7759/cureus.56357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
Pemphigus vulgaris is a chronic autoimmune disease of the skin caused by the production of autoantibodies targeting desmogleins 1 and 3 usually presenting in individuals with an average age of onset of approximately 40 years. A 35-year-old obese, diabetic woman presented with fluid-filled lesions over her body for three months along with erosions and painful ulcers in her mouth and genital area for two months. Based on clinical and histopathological studies, the patient was diagnosed as a case of pemphigus vulgaris. She was started on conventional treatment with oral corticosteroids followed by pulse therapy and mycophenolate mofetil. Rituximab infusion was scheduled but could not be administered due to elevated D-dimer values. The patient underwent screening for deep vein thrombosis (DVT) and received subcutaneous enoxaparin and oral rivaroxaban. She developed severe sepsis for which she was treated with systemic antibiotics. She subsequently developed acute renal failure and underwent hemodialysis. The patient's clinical condition further deteriorated, which necessitated therapeutic plasma exchange (TPE). Collagen, colloidal silver, and silicone foam dressings were done to hasten wound healing. Two distinct approaches were employed to eliminate the pseudomembrane on the wounds. One portion was treated with hydrogen peroxide (H2O2), while the other was with hyaluronidase. The hyaluronidase treatment resulted in considerable improvement of the lesions. Intravenous immunoglobulin (IVIG) infusion was scheduled. However, the treatment could not be administered as the patient succumbed to death due to pulmonary thromboembolism (PTE) secondary to DVT.
Collapse
Affiliation(s)
- Priya Garg
- Dermatology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Kshitiz Lakhey
- Dermatology, Venereology, and Leprosy, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Nishtha Mishra
- Dermatology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Yash Buccha
- Dermatology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Kirti S Deo
- Dermatology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| |
Collapse
|
2
|
Han K, Li SS, Pan W, Xu MN, Zhong MZ, Zhang WJ, Huang XW, Zeng K. ERK/MEK Pathway Regulates Th17 Cell Differentiation in Patients with Pemphigus Vulgaris. Indian J Dermatol 2023; 68:724. [PMID: 38371571 PMCID: PMC10868988 DOI: 10.4103/ijd.ijd_924_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Background T helper (Th) cells are involved in the pathogenesis of pemphigus vulgaris (PV). However, the mechanism still needs more exploration. Aims This study aimed to evaluate the molecular mechanism of the dysregulation of Th17 cells in the peripheral blood of patients with PV. Materials and Methods Serum levels of IL-17 and anti-Dsg3 titres in patients with PV were analysed using ELISA. The mRNA expression of retinoic acid orphan receptor γt (RORγt) in CD4+ T cells was detected using reverse transcription-quantitative PCR (qPCR). The number of Th17 cells was examined using flow cytometry. Western blot analysis and immunofluorescent staining were also performed to investigate the expression levels of ERK/MAPK signalling proteins and Th17 lineage-associated proteins. Results The proportion of Th17 cells and Th17 spectrum-associated proteins (p-STAT3, RORγt and IL-17) were upregulated in CD4+ cells in PV patients. The increased transcriptional levels of RORγt and IL-17 correlated positively with the severity of PV. Elevated phosphorylation of the ERK signalling factors was found in the collected CD4+ T cells in PV patients. The inhibition of the ERK signalling pathway significantly reduced the differentiation of Th17 cells in PV patients in vitro. Conclusion Th17 cells are essential in the dysregulation of PV, and ERK signalling is involved in Th17-type immunity and promotes the development of PV. The study here provides us with a potential therapeutic target for PV.
Collapse
Affiliation(s)
- Kai Han
- From the Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Song-Shan Li
- From the Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen Pan
- Division of Infectious Diseases, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Mei-Nian Xu
- From the Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Mei-Zhen Zhong
- From the Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen-Jing Zhang
- From the Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao-Wen Huang
- From the Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Kang Zeng
- From the Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
3
|
Einhaus J, Han X, Feyaerts D, Sunwoo J, Gaudilliere B, Ahmad SH, Aghaeepour N, Bruckman K, Ojcius D, Schürch CM, Gaudilliere DK. Towards multiomic analysis of oral mucosal pathologies. Semin Immunopathol 2023; 45:111-123. [PMID: 36790488 PMCID: PMC9974703 DOI: 10.1007/s00281-022-00982-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/23/2022] [Indexed: 02/16/2023]
Abstract
Oral mucosal pathologies comprise an array of diseases with worldwide prevalence and medical relevance. Affecting a confined space with crucial physiological and social functions, oral pathologies can be mutilating and drastically reduce quality of life. Despite their relevance, treatment for these diseases is often far from curative and remains vastly understudied. While multiple factors are involved in the pathogenesis of oral mucosal pathologies, the host's immune system plays a major role in the development, maintenance, and resolution of these diseases. Consequently, a precise understanding of immunological mechanisms implicated in oral mucosal pathologies is critical (1) to identify accurate, mechanistic biomarkers of clinical outcomes; (2) to develop targeted immunotherapeutic strategies; and (3) to individualize prevention and treatment approaches. Here, we review key elements of the immune system's role in oral mucosal pathologies that hold promise to overcome limitations in current diagnostic and therapeutic approaches. We emphasize recent and ongoing multiomic and single-cell approaches that enable an integrative view of these pathophysiological processes and thereby provide unifying and clinically relevant biological signatures.
Collapse
Affiliation(s)
- Jakob Einhaus
- Department of Anesthesiology, Perioperative & Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA.,Department of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, Tübingen, Germany
| | - Xiaoyuan Han
- Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA
| | - Dorien Feyaerts
- Department of Anesthesiology, Perioperative & Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - John Sunwoo
- Division of Head and Neck Surgery, Department of Otolaryngology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Brice Gaudilliere
- Department of Anesthesiology, Perioperative & Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Somayeh H Ahmad
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, 770 Welch Road, Palo Alto, CA, 94304, USA
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative & Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Karl Bruckman
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, 770 Welch Road, Palo Alto, CA, 94304, USA
| | - David Ojcius
- Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA
| | - Christian M Schürch
- Department of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, Tübingen, Germany
| | - Dyani K Gaudilliere
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, 770 Welch Road, Palo Alto, CA, 94304, USA.
| |
Collapse
|
4
|
How important is subjective well-being for patients? A qualitative interview study of people with psoriasis. Qual Life Res 2022; 31:3355-3363. [PMID: 35948788 PMCID: PMC9587968 DOI: 10.1007/s11136-022-03189-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE This qualitative study aimed to investigate the importance of subjective well-being (SWB) as an outcome of psoriasis treatment from patient's perspective. We focused on the affective component of SWB as assessed with the Daily Experience Sampling Questionnaire (DESQ), a validated daily diary. METHODS Semi-structured qualitative telephone interviews were conducted with in-patients of a dermatological rehabilitation clinic, after participants had completed the DESQ for up to seven days to get familiar with the concept of SWB. Patients were asked to reflect on the importance of SWB as treatment goal and on its relative importance as compared with other treatment outcomes. We also addressed whether SWB could be an indirect measure of benefit in that it reflects other important outcomes. Transcripts were analyzed using content analysis. RESULTS Eleven patients participated (24-63 years, mean 53 years, 8 male, 3 female). Participants uniformly confirmed that changes in SWB reflected treatment benefit. All but one considered SWB to be a central aspect of treatment benefit-either as the most important treatment goal or as an indirect benefit indicator. In particular, participants described positive associations of SWB with other outcomes, such as symptoms. They reported that both the disease and the medical treatment had an impact on their SWB, which was reflected in the DESQ. CONCLUSION Our findings suggest that SWB is a relevant indicator of treatment benefit for patients with psoriasis. Therefore, SWB measures, such as the DESQ, could be used to operationalize patient-relevant benefit of psoriasis treatment, complementing outcome measures currently used.
Collapse
|
5
|
Carvalho KM, Dhupar A, Spadigam A, Naik MV. Pemphigus vulgaris in an elderly woman diagnosed with subacute thyroiditis: A case report. Aging Med (Milton) 2022; 5:145-149. [PMID: 35783118 PMCID: PMC9245171 DOI: 10.1002/agm2.12202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/15/2022] [Accepted: 02/27/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Karla Maria Carvalho
- Department of Oral and Maxillofacial Pathology Goa Dental College and Hospital Bambolim India
| | - Anita Dhupar
- Department of Oral and Maxillofacial Pathology Goa Dental College and Hospital Bambolim India
| | - Anita Spadigam
- Department of Oral and Maxillofacial Pathology Goa Dental College and Hospital Bambolim India
| | - Meghna Virendra Naik
- Department of Oral and Maxillofacial Pathology Goa Dental College and Hospital Bambolim India
| |
Collapse
|
6
|
Maldonado-Paredes SE, Juárez-Cedillo T, Godínez-Escobar KJ, Contreras-Rodríguez Y, Gallegos-De Luna CF, Alanis-Ocádiz A. [Pemphigus vulgaris with exclusive affectation in the esophagus: a case report]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2022; 60:75-79. [PMID: 35274914 PMCID: PMC10395950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
Background Pemphigus vulgaris comprises a group of heterogeneous blistering autoimmune diseases of the skin and mucosa. Esophageal involvement within pemphigus vulgaris is rare with an uncertain prevalence that requires a detailed diagnostic and a therapeutic approach. Clinical case 37-year-old female, with a history of treatment with Cox-2 inhibitors due to herniated disc. She is sent to the Gastroenterology Service for weight loss of approximately 5 kilos in a month, with the presence of dysphagia, odynophagia and retrosternal pain with poor tolerance to the oral route. Endoscopy was performed, which reported esophagitis dissecans superficialis (EDS), erythematous gastropathy of the antrum and normal duodenum. Findings were correlated with the diagnosis of pemphigus vulgaris with exclusive involvement of the esophagus. The evaluation did not identify lesions on the skin, oral cavity or other mucous membranes. A new endoscopy was performed as a control and it was found immunofluorescence of the esophageal biopsy reactive to IgG 2. Initial management was given with glucocorticoids, anti-inflammatories and immunosuppressants. Conclusions The importance of the study of pemphigus lies not only in the high associated morbidity and mortality, but also in its intrinsic rarity and the complexity of its detection, given that patients usually take several months to have an accurate diagnosis and even more time to achieve therapeutic goals. It is a priority the dissemination of the study of pemphigus among health professionals involved in its detection.
Collapse
Affiliation(s)
- Sarahi Estrella Maldonado-Paredes
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 11, Servicio de Consulta Externa. Aguascalientes, Aguascalientes, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Teresa Juárez-Cedillo
- Instituto Mexicano del Seguro Social, Unidad de Investigación en Epidemiología y en Servicios de Salud, Área Envejecimiento. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Keren Jared Godínez-Escobar
- Universidad Autónoma de Aguascalientes, Centro de Ciencias de la Salud, Departamento de Medicina. Aguascalientes, Aguascalientes, MéxicoUniversidad Autónoma de AguascalientesMéxico
| | - Yosafat Contreras-Rodríguez
- Universidad Autónoma de Aguascalientes, Centro de Ciencias de la Salud, Departamento de Medicina. Aguascalientes, Aguascalientes, MéxicoUniversidad Autónoma de AguascalientesMéxico
| | - Carlos Francisco Gallegos-De Luna
- Universidad Autónoma de Aguascalientes, Centro de Ciencias de la Salud, Departamento de Medicina. Aguascalientes, Aguascalientes, MéxicoUniversidad Autónoma de AguascalientesMéxico
| | - Alicia Alanis-Ocádiz
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 8, Aguascalientes, Aguascalientes, MéxicoInstituto Mexicano del Seguro SocialMéxico
| |
Collapse
|
7
|
Huang S, Hsu S, Motaparthi K. Vesiculobullous Diseases. Medicina (B Aires) 2022; 58:medicina58020186. [PMID: 35208511 PMCID: PMC8876315 DOI: 10.3390/medicina58020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
Abstract
A diverse range of inflammatory dermatoses are characterized by vesicles or bullae [...]
Collapse
Affiliation(s)
- Simo Huang
- Department of Dermatology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (S.H.); (S.H.)
| | - Sylvia Hsu
- Department of Dermatology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (S.H.); (S.H.)
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL 32606, USA
- Correspondence:
| |
Collapse
|
8
|
Ninković-Baroš Đ, Balaban J, Umićević-Šipka S, Gajanin V. Relationship between the age and sex of the patient with the results of the indirect immunofluorescence test in patients with bullous dermatoses. SCRIPTA MEDICA 2022. [DOI: 10.5937/scriptamed53-37483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background/Aim: Autoimmune bullous diseases are characterised by the production of autoantibodies to epidermal or subepidermal adhesive proteins. The aim of this study was to determine the relationship between age and sex of patients with the results of indirect immunofluorescence test in patients with newly diagnosed bullous dermatoses. Methods: The investigation presents a retrospective study of newly diagnosed patients with autoimmune bullous diseases at the Clinic for Skin and Venereal Diseases of the University Clinical Centre in Banja Luka in the period 2016-2021. In addition to demographic data, the results of an indirect immunofluorescence test in two titres (≥ 1:10 and ≥ 1:100) were analysed. Results: In this study, almost the same number of patients with pemphigus (45.2 %) and pemphigoid (54.8 %) was found. There were more women than men in the total sample (p = 0.049). The average age of subjects with pemphigoid was higher than that of patients with pemphigus (p = 0.001). 48.2 % of patients with pemphigus and 51.8 % of patients with pemphigoid had a positive indirect immunofluorescence test. A positive test for epidermal intercellular substance in both sexes at a titre ≥ 1:100 is higher than a titre ≥ 1:10 (p = 0.029). Patients with autoantibody titres ≥ 1:100 to desmoglein-1 were statistically significantly older than patients with titres ≥ 1:10 (p = 0.047). Conclusion: Number of patients with pemphigus and pemphigoid were similar, with no difference in sex distribution between the two groups of patients, but patients with pemphigoid were older than patients with pemphigus. The difference between high and low autoantibody titres in both sexes was found only in the group of pemphigus on epidermal intercellular substance and desmoglein-1.
Collapse
|
9
|
Moussaoui E, Oueslati Y, Oualha L, Denguezli M, Sriha B, Douki N. Simultaneous Oral and Umbilical Locations as a First Sign of Pemphigus Vulgaris. Case Rep Dent 2021; 2021:7792360. [PMID: 34733562 PMCID: PMC8560286 DOI: 10.1155/2021/7792360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 10/09/2021] [Indexed: 11/17/2022] Open
Abstract
The place of pemphigus vulgaris (PV) among autoimmune bullous diseases (AIBD) is well established. It is an acquired chronic, autoimmune, vesiculobullous disease in which IgG antibodies target desmosomal proteins to produce intraepithelial mucocutaneous blistering. The diagnosis is often challenging for the clinicians. It requires a combination of three major features: clinical, histopathological, and immunological. Clinically, oral lesions are the first manifestations of the disease in 50-90% of the patients with widespread blisters affecting the oral mucosa. On the skin, lesions are characterized by flaccid blisters that rapidly progress into erosions and crust formation. Umbilical lesions as a clinical manifestation of PV are peculiar and have rarely been reported, and they are not yet completely elucidated. Umbilical region involvement in patients with pemphigus was assessed in a limited study totalling just 10 patients. This localisation may be a valuable hint easing the diagnosis at the clinical level for patients with oral mucosal blisters. Dentists must be familiar with the clinical manifestations of PV to make an early diagnosis and start an early treatment which determines the prognosis of the disease. To the best of the authors' knowledge, the coexistence of these lesions with the oral lesions as a first sign of PV in the absence of skin involvement was reported in only one case of pemphigus vegetans (PVe). In this paper, we describe an observation of a female patient that was diagnosed with PV that begun with simultaneous oral and umbilical locations which coexisted for a period of 4 months before the appearance of other cutaneous lesions. We highlight the role of dentists, by being familiar with the clinical manifestations of PV, to make an early diagnosis to start an early treatment which determines the prognosis of the disease and to follow closely the evolution of lesions to change treatment if required. We also discuss the clinical, histological, and immunological features of the disease that enabled the differential diagnosis as well as the appropriate therapeutic management.
Collapse
Affiliation(s)
- Eya Moussaoui
- Department of Dental Medicine, Sahloul Hospital (Sousse), Dental Faculty of Monastir, University of Monastir, Tunisia
- Laboratory of Oral Health and Maxillofacial Rehabilitation (LR12ES11), University of Monastir, Tunisia
| | - Yassine Oueslati
- Department of Dental Medicine, Sahloul Hospital (Sousse), Dental Faculty of Monastir, University of Monastir, Tunisia
- Laboratory of Oral Health and Maxillofacial Rehabilitation (LR12ES11), University of Monastir, Tunisia
| | - Lamia Oualha
- Department of Dental Medicine, Sahloul Hospital (Sousse), Dental Faculty of Monastir, University of Monastir, Tunisia
- Laboratory of Oral Health and Maxillofacial Rehabilitation (LR12ES11), University of Monastir, Tunisia
| | - Mohamed Denguezli
- Dermatology Department, Farhat Hached Hospital (Sousse), University of Sousse, Tunisia
| | - Badreddine Sriha
- Cytology and Pathological Anatomy Department, Farhat Hached Hospital (Sousse), University of Sousse, Tunisia
| | - Nabiha Douki
- Department of Dental Medicine, Sahloul Hospital (Sousse), Dental Faculty of Monastir, University of Monastir, Tunisia
- Laboratory of Oral Health and Maxillofacial Rehabilitation (LR12ES11), University of Monastir, Tunisia
| |
Collapse
|
10
|
Malik AM, Tupchong S, Huang S, Are A, Hsu S, Motaparthi K. An Updated Review of Pemphigus Diseases. Medicina (B Aires) 2021; 57:medicina57101080. [PMID: 34684117 PMCID: PMC8540565 DOI: 10.3390/medicina57101080] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/26/2021] [Accepted: 09/28/2021] [Indexed: 01/19/2023] Open
Abstract
Clinicians may encounter a variety of skin conditions that present with vesiculobullous lesions in their everyday practice. Pemphigus vulgaris, pemphigus foliaceus, IgA pemphigus, and paraneoplastic pemphigus represent the spectrum of autoimmune bullous dermatoses of the pemphigus family. The pemphigus family of diseases is characterized by significant morbidity and mortality. Considering the risks associated with a delayed diagnosis or misdiagnosis and the potential for overlap in clinical features and treatment, evaluation for suspected pemphigus disease often requires thorough clinical assessment and laboratory testing. Diagnosis is focused on individual biopsies for histopathology and direct immunofluorescence. Additional laboratory methods used for diagnosis include indirect immunofluorescence and enzyme-linked immunosorbent assay. Recent advancements, including anti-CD20 therapy, have improved the efficacy and reduced the morbidity of pemphigus treatment. This contribution presents updates on the pathophysiology, clinical features, diagnostic work-up, and medical management of pemphigus. Improved strategies for diagnosis and clinical assessment are reviewed, and newer treatment options are discussed.
Collapse
Affiliation(s)
- Ali M. Malik
- College of Medicine, University of Florida, Gainesville, FL 32606, USA; (A.M.M.); (A.A.)
| | - Sarah Tupchong
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA;
| | - Simo Huang
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (S.H.); (S.H.)
| | - Abhirup Are
- College of Medicine, University of Florida, Gainesville, FL 32606, USA; (A.M.M.); (A.A.)
| | - Sylvia Hsu
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (S.H.); (S.H.)
| | - Kiran Motaparthi
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL 32606, USA
- Correspondence:
| |
Collapse
|
11
|
Boda D, Caruntu C. Highlights of the 3rd conference of the Romanian Association of Immuno-Dermatology and the 37th conference of the Romanian Society of Immunology held in Bucharest between September 19 and 22, 2019. Exp Ther Med 2019; 18:4953-4955. [PMID: 31798716 PMCID: PMC6880389 DOI: 10.3892/etm.2019.8174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/07/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Daniel Boda
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Constantin Caruntu
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| |
Collapse
|
12
|
Sadaksharam J. Current Therapeutic Modalities of Immunobullous Lesions. Contemp Clin Dent 2019; 10:407-409. [PMID: 32308311 PMCID: PMC7150570 DOI: 10.4103/ccd.ccd_464_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Jayachandran Sadaksharam
- Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College and Hospital (Affiliated to TN Dr. MGR Medical University), Chennai, Tamil Nadu, India E-mail:
| |
Collapse
|