British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris 2017

Harman, K. E.; Brown, D.; Exton, L.S.; Groves, Richard; Hampton, Philip; Mustapa, M.F. Mohd; Setterfield, Jane; Yesudian, Patrick

doi:10.1111/bjd.15930

Cited by 208 publications

(298 citation statements)

References 287 publications

(411 reference statements)

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“…The evolution of PV typically begins with painful mucosal ulceration, especially in the mouth . These ulcers are persistent; individual ulcers may come and go but new lesions continue to appear.…”

Section: Diagnostic Cluesmentioning

confidence: 99%

Pemphigus vulgaris and pemphigus foliaceus: an overview of the clinical presentation, investigations and management

Melchionda

Harman

2019

Clin Exp Dermatol

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Section: Diagnostic Cluesmentioning

confidence: 99%

Pemphigus vulgaris and pemphigus foliaceus: an overview of the clinical presentation, investigations and management

Melchionda

Harman

2019

Clin Exp Dermatol

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“…According to study on 155 patients on immunosuppressive therapy 94 patients developed secondary infections 9 . Some studies have showed that low-level laser therapy can provide immediate and signifi cant analgesia in patients with pemphigus vulgaris 10 . Systemic corticosteroids are the most useful drugs in the treatment of pemphigus vulgaris and continue to be the mainstay of therapy for this disease.…”

Section: Case-reportmentioning

confidence: 99%

“…Systemic corticosteroids are the most useful drugs in the treatment of pemphigus vulgaris and continue to be the mainstay of therapy for this disease. Their use rapidly induces remission in the majority of patients but the clinician must weigh the benefi ts against the hazard from side effects of the drug 9,10 .…”

Section: Case-reportmentioning

confidence: 99%

Oral pemphigus vulgaris

Sharma¹

2017

J. Kathmandu Med. Coll.

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Pemphigus is a group of potentially life-threatening autoimmune mucocutaneous diseases characterized by epithelial blistering affecting cutaneous and/ or mucosal surfaces. Pemphigus affects 0.1-0.5 patients per 100,000 population per year. Oral lesions of pemphigus are seen in up to 18% of patients at dermatology out-patient clinics, but despite the frequency of oral involvement, and novel therapeutic approaches, there are surprisingly few recent studies of either the oral manifestations of pemphigus or their management, and delays in diagnosis are still common. Most patients are initially misdiagnosed and improperly treated for many months or even years. Dental professionals must be suffi ciently familiar with the clinical manifestations of pemphigus vulgaris to ensure early diagnosis and treatment, since this in turn determines the prognosis and course of the disease. Pemphigus has been reviewed in the oral literature in the past decade 4 , but several advances in the understanding of the etiopathogenesis, pemphigus variants, and management warrant an update. Here, we report a case of pemphigus vulgaris that was misdiagnosed in its earliest stage. Oral ulceration may arise from a variety of causes. This case illustrates that, although rare, pemphigus vulgaris may need to be included in differential diagnosis.

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“…An effective initial dose of corticosteroids has been suggested to be 1 mg/kg/d [9]. Others recommend an initial oral prednisolone dose of 40-60 mg/d and with severe PV, 60-100 mg/d [10]. A randomized control trial of 20 patients showed that pulsed oral dexamethasone (300 mg/d for 3 days) in addition to oral prednisolone and azathioprine does not improve time to remission, duration of remission or mortality.…”

Section: Systemic Corticosteroidsmentioning

confidence: 99%

Pemphigus vulgaris: approach to treatment

Sinha¹,

Hoffman²,

Janicke³

2015

European Journal of Dermatology

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The therapeutic management of pemphigus vulgaris (PV) is centered around immunosuppression, which can be generalized, as in the use of corticosteroids or steroid sparing agents, or specific, as in therapeutic blockage of autoantibody production, certain cytokines, or signaling pathways. Currently, the backbone of treatment for PV, particularly, first line therapy, remains systemic corticosteroids. Although very effective, the significant side effects of long-term corticosteroid usage are well documented. Adjunctive therapies aim to eliminate, or at least decrease, the necessary dose of corticosteroids. Specifically, azathioprine, cyclophosphamide, methotrexate, cyclosporine, mycophenolate mofetil and dapsone are now widely used in PV. Intravenous immunoglobulin (IVIG), plasmapheresis, immunoadsorption, and most recently, rituximab, are other members of the therapeutic armamentarium. However, despite the widening range of treatment options in PV, well-controlled clinical trials and consensus guidelines are lacking.

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British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris 2017

Abstract: Plain language summary available online

Cited by 208 publications

References 287 publications

Pemphigus vulgaris and pemphigus foliaceus: an overview of the clinical presentation, investigations and management

Pemphigus vulgaris and pemphigus foliaceus: an overview of the clinical presentation, investigations and management

Oral pemphigus vulgaris

Pemphigus vulgaris: approach to treatment

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