An unusual case of pemphigus vulgaris presenting as bilateral foot ulcers

Tan, Hiok‐Hee; Tay, Yong–Kwang

doi:10.1046/j.1365-2230.2000.00622.x

Cited by 15 publications

(12 citation statements)

References 13 publications

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“…Periungual localization of pemphigus is rare [2,3,4,5,6,7]. It has been claimed that this complication occurs more frequently in eastern populations, as observed in our 2 cases.…”

Section: Commentssupporting

confidence: 62%

“…In our cases, the clinical presentation was striking with oral involvement and isolated periungual lesions. Out of the 25 cases of paronychial pemphigus reported in the literature, an oral localization was present in 21 patients (84% of the cases) [2,3,4,5,6,7]. In the series of Schlesinger et al [1], the presence of mucous membrane involvement was unfortunately not specified.…”

Section: Commentsmentioning

confidence: 99%

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Orodigital Pemphigus Vulgaris: A Pathogenic Role of Anti-Desmoglein-3 Autoantibodies in Pemphigus Paronychia?

2008

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Paronychia is a rare complication of pemphigus vulgaris (PV), and the immunological profile of patients with digital disease has not been assessed so far. We report 2 cases of PV with oral mucosa and periungual involvement, who had high titers of anti- desmoglein (Dsg)-3 circulating antibodies. These observations raise the possibility that expression of Dsg-1 and Dsg-3 in distinct areas of periungual skin is disease specific and that anti-Dsg-3 antibodies alone may have an as yet unrecognized importance for the development of paronychia in PV.

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“…Periungual localization of pemphigus is rare [2,3,4,5,6,7]. It has been claimed that this complication occurs more frequently in eastern populations, as observed in our 2 cases.…”

Section: Commentssupporting

confidence: 62%

Section: Commentsmentioning

confidence: 99%

Orodigital Pemphigus Vulgaris: A Pathogenic Role of Anti-Desmoglein-3 Autoantibodies in Pemphigus Paronychia?

2008

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“…Back in 1976, a review of 107 consecutive cases of pemphigus demonstrated dapsone to be a useful adjuvant to systemic corticosteroids [10] . Since then, dapsone's efficacy as a steroid-sparing agent in the treatment of PV has been documented in several reports [11][12][13][14][15][16][17][18][19][20] . However, the current data are mainly based on small retrospective case series and reports.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study

Baum¹,

Debby²,

Gilboa³

et al. 2016

Dermatology

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Background: Pemphigus vulgaris (PV) is a chronic autoimmune blistering disease. Most patients require long-term therapy with systemic steroids, and a steroid-sparing agent is usually also utilized. Dapsone is a chemotherapeutic agent with anti-inflammatory properties that is used as a steroid-sparing agent in PV. Objective: The aim of the present study was to evaluate the efficacy of dapsone as an adjuvant therapy in patients with PV. Methods: A retrospective analysis of patients' files was performed. All 26 patients included in the study group were treated with dapsone as an adjuvant to systemic steroids for at least 3 consecutive months and were followed up during their dapsone treatment period. Results: After 3 months of treatment with dapsone, 13 patients were in the consolidation phase, 4 patients demonstrated partial remission on minimal therapy, 7 patients demonstrated complete remission on minimal therapy, and 2 patients were defined as treatment failures. The trend of clinical improvement continued after 6 months of treatment and at the study end point. Conclusion: This retrospective case series, one of the largest reported, indicates that dapsone is efficacious and safe for patients with PV in whom it is well tolerated soon after the initiation of treatment.

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“…[7][8][9][10][11][12][13][14][15][16][17][18][19] Dapsone was used as monotherapy in six (16%) patients. There were 37 patients in 13 reports who were treated with dapsone.…”

Section: Pemphigus Vulgarismentioning

confidence: 99%

“…[8,9,11,[14][15][16]18] In three patients, prednisone was discontinued; in seven patients, the dose of prednisone prior to initiation of dapsone was reduced. [8,9,11,[14][15][16]18] In three patients, prednisone was discontinued; in seven patients, the dose of prednisone prior to initiation of dapsone was reduced.…”

Section: Pemphigus Vulgarismentioning

confidence: 99%

Efficacy of Dapsone in the Treatment of Pemphigus and Pemphigoid

Gürcan

Ahmed

2009

American Journal of Clinical Dermatology

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Dapsone is a chemotherapeutic agent primarily used in treating leprosy, Pneumocystis jiroveci (previously carinii) pneumonia, and malaria. It is also used as an adjuvant in the treatment of pemphigus and pemphigoid. To assess the role of dapsone in the treatment of pemphigus and pemphigoid, a retrospective review of reports in the English-language literature was conducted. Information on the number of patients treated, their average age, prior therapies, indications for use, protocol (dose and interval) used, concomitant therapies, reported adverse effects, and clinical outcomes were analyzed. There were 35 case reports/series published describing the use of dapsone in a total of 427 patients. Data on 55 pemphigus patients were obtained from several case reports and some case series and one randomized controlled trial. Of these, 32 patients with pemphigus vulgaris and 14 patients with pemphigus foliaceus responded to dapsone. Data from 13 case series, each including at least five patients, accounted for 372 patients with pemphigoid. The overall response rates to dapsone, when given either alone or in combination with corticosteroids or immunosuppressive agents, were 84% in mucous membrane pemphigoid, and 81% in bullous pemphigoid. Hemolysis was the most common adverse effect observed. Dapsone is a promising and useful agent in patients with autoimmune mucocutaneous blistering diseases, especially in mucous membrane pemphigoid. It can be used as a corticosteroid-sparing agent. Therefore, its combined use with oral corticosteroids may be useful in pemphigus vulgaris and bullous pemphigoid. Adverse effects of dapsone are dose dependent and usually reversible. Hemolysis and concomitant anemia secondary to hemolysis are expected in most patients. In the opinion of the authors, dapsone is underutilized in the treatment of autoimmune mucocutaneous blistering diseases.

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An unusual case of pemphigus vulgaris presenting as bilateral foot ulcers

Cited by 15 publications

References 13 publications

Orodigital Pemphigus Vulgaris: A Pathogenic Role of Anti-Desmoglein-3 Autoantibodies in Pemphigus Paronychia?

Orodigital Pemphigus Vulgaris: A Pathogenic Role of Anti-Desmoglein-3 Autoantibodies in Pemphigus Paronychia?

Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study

Efficacy of Dapsone in the Treatment of Pemphigus and Pemphigoid

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