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A Novel Immunomodulatory Agent

Hossein C. Nousari, MD; Grant J. Anhalt, MD

Arch Dermatol. 2000;136:1204-1205.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF CASES

CASE 1

A 70-year-old white woman presented with an 8-month history of worsening pruritus of the trunk and extremities, urticarial plaques on the trunk, and a few erythematous-based vesicobullous lesions on the lower extremities. She had a history of severe osteoporosis that was complicated by several vertebral fractures and incapacitating scoliosis. Her medications included pamidronate, calcitonin, calcium, and vitamin D. Histologic examination of the urticarial and bullous lesions showed a subepidermal blister with an intense eosinophilic infiltrate. Immunopathologic studies of the skin and serum samples confirmed the diagnosis of bullous pemphigoid. Prednisone therapy (30 mg/d [0.75 mg/kg per day]) was initiated. Complete resolution of the lesions and pruritus was achieved within 4 weeks, and the dosage of prednisone was tapered to 20 mg/d. A further tapering of the dosage of prednisone, to 15 mg/d, was associated with a significant flare of the disease. The . . . [Full Text of this Article]

CASE 2

THERAPEUTIC CHALLENGE

COMMENT

From the Johns Hopkins Medical Institutions, Baltimore, Md.