Bullous pemphigoid in a renal transplant recipient

Cavaliere, Giovanni; Fava, Paolo; Bussolino, Stefania; Manzione, Ana Maria; Savoia, Paola

doi:10.1684/ejd.2014.2316

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…However, specific studies on the use of dapsone in patients with concurrent ESKD and pemphigoid diseases are limited. This kind of treatment was reported in eight cases and benefited four patients with an average reported dose of 62.5 mg/day ( 20 , 72 , 74 , 75 ). Adverse effects including epigastric pain and mild hypertension were reported ( 73 ).…”

Section: Resultsmentioning

confidence: 99%

“…Among recalcitrant patients, two cases only used topical steroids, and others used prednisolone with the average daily dose of 50 mg. Triggers removal benefited patients who responded minimally to corticosteroid, suggesting the importance of triggers identification. After tapering or stopping the dose of corticosteroids, five patients relapsed ( 38 , 39 , 50 , 72 , 73 ). Severe infection was reported in one case ( 6 ).…”

Section: Resultsmentioning

confidence: 99%

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Pemphigoid diseases in patients with end-stage kidney diseases: pathogenesis and treatment

Yang,

Wang,

Zuo

2024

Front. Immunol.

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BackgroundPemphigoid diseases constitute a group of autoimmune blistering disorders characterized by subepithelial blistering. The association between pemphigoid diseases and both end-stage kidney disease (ESKD) and its treatment is notable. However, there is limited evidence about the management of pemphigoid diseases in patients with ESKD. This systematic review compiled case reports and relevant studies, summarized the underlying mechanisms of pemphigoid diseases in patients with ESKD, and summarized the efficacy of various therapies.MethodsA systematic search of PubMed and Embase was performed for articles published between 1982 to June 2, 2024.ResultsFifty-three case reports and eight relevant studies were included. Triggers for pemphigoids in patients with ESKD included materials used to treat ESKD, immune dysregulation of patients with ESKD, and rejection of renal allograft. Treatment for these patients included removing triggers, as well as administering of corticosteroids, mycophenolate mofetil (MMF), tetracyclines, rituximab, methotrexate, dapsone, azathioprine, cyclosporine, intravenous immunoglobin (IVIG), plasmapheresis, and Janus kinase inhibitors.ConclusionRemoving triggers is the most effective strategy. Despite their suboptimal efficacy, corticosteroids remain the most commonly used agents in this patient population. MMF, tetracyclines, and rituximab are less used but with benefits. There are significant adverse effects associated with methotrexate treatment. Other treatment may also be beneficial and require further investigation. These findings may enable clinicians to optimize the therapeutic approach for these patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Pemphigoid diseases in patients with end-stage kidney diseases: pathogenesis and treatment

Yang,

Wang,

Zuo

2024

Front. Immunol.

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“…In a previous study performed to evaluate the incidence of cutaneous diseases in a group of 282 kidney transplant recipients, we reported that inflammatory conditions occur in 14.9% of patients [14], in agreement with previous studies [6,7]; an even lower occurrence of inflammatory diseases in transplanted patients was scored by [8], with only a few cases of acneiform eruptions, rosacea, asteatotic eczema, contact eczema and stasis dermatitis. Notably, the incidence of skin diseases with an immunologic pathogenesis is considered to be an even more uncommon event, with only a few sporadic cases reported [14,15]. Many immunosuppressive drugs—such as tacrolimus, cyclosporine, and mycophenolate—are approved both for preventing chronic transplant rejection and for the treatment of inflammatory skin diseases [9,15,16,17]; this dual therapeutic role can easily explain the observed reduced incidence of inflammatory skin diseases in transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, the incidence of skin diseases with an immunologic pathogenesis is considered to be an even more uncommon event, with only a few sporadic cases reported [14,15]. Many immunosuppressive drugs—such as tacrolimus, cyclosporine, and mycophenolate—are approved both for preventing chronic transplant rejection and for the treatment of inflammatory skin diseases [9,15,16,17]; this dual therapeutic role can easily explain the observed reduced incidence of inflammatory skin diseases in transplant recipients. In the present study, we observed inflammatory skin diseases in less than 15% of our kidney transplant recipients, versus a more than 60% incidence in the general population [14].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Cutaneous Diseases in Renal Transplant Recipients

Savoia

Cavaliere

Zavattaro

et al. 2016

IJMS

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Kidney transplant recipients frequently suffer from skin infections and malignancies, possibly due to the effects of long-term immunosuppressive therapy. While the relationships between immunosuppression and these pathological conditions have been widely investigated, little is known about the relative incidence and characteristics of inflammatory skin diseases in this type of patient. In this study, we analyze the incidence of a number of inflammatory cutaneous diseases in a cohort of patients who underwent kidney transplantation. Although our study shows a relatively low incidence of these pathologies in transplanted patients—in agreement with the general action of immunosuppressant therapies in reducing inflammation—we scored a different efficacy of the various immunosuppressive regimens on inflammatory and autoimmune skin diseases. This information can be key for designing immunosuppressive regimens and devising accurate follow-up protocols.

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