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Successful Treatment of Recalcitrant Pemphigus Vulgaris and Pemphigus Vegetans With Etanercept and Carbon Dioxide Laser
Ming-Hsien Lin, MD;
Chao-Kai Hsu, MD;
Julia Yu-Yun Lee, MD
College of Medicine, National Cheng Kung University
Arch Dermatol. 2005;141:680-682.
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REPORT OF A CASE
A 26-year-old woman presented with a 5-month history of painful oral erosions and a 1-month history of widespread flaccid vesicles over her face and torso. A biopsy specimen of a skin lesion revealed suprabasal acantholysis. The diagnosis of pemphigus vulgaris (PV) was confirmed by a positive intercellular (IC) antibody titer. The patient was treated with prednisolone (30-45 mg/d) combined with other immunosuppressive agents, including azathioprine (100 mg/d), cyclophosphamide (100 mg/d), methotrexate sodium (15 mg/wk), mycophenolate mofetil (1 g/d), and dapsone (100 mg/d), at different times over a 2-year period. The clinical course was complicated by episodes of severe flare, with hemorrhagic paronychia and onychomadesis that required pulse therapy with methylprednisolone, with or without cyclophosphamide, and intravenous immunoglobulin therapy. The disease proved to be recalcitrant to all these medications. The circulating IC antibody titer was 1:640. The treatments were associated with . . . [Full Text of this Article]
THERAPEUTIC CHALLENGE
SOLUTION
COMMENT
AUTHOR INFORMATION
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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Novel Mechanisms of Target Cell Death and Survival and of Therapeutic Action of IVIg in Pemphigus
Arredondo et al.
Am. J. Pathol. 2005;167:1531-1544.
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