Management of Acquired Bullous Skin Diseases

Fine, Jo‐David

doi:10.1056/nejm199511303332207

Cited by 108 publications

(59 citation statements)

References 112 publications

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“…Since some immunosuppressant agents need several weeks to induce therapeutically relevant immunosuppression, we prefer to treat BP initially with an oral combination of corticosteroids plus immunosuppressant drug. The most frequent adjuvant agent is azathioprine, [15][16][17]19 which has been used successfully for nearly 4 decades, in a range between 1.5 and 3.0 mg/kg. Our findings concur with the reported efficacy of combination azathioprine/corticosteroid treatment in patients with BP.…”

Section: Commentmentioning

confidence: 99%

A Comparison of Oral Methylprednisolone Plus Azathioprine or Mycophenolate Mofetil for the Treatment of Bullous Pemphigoid

Beissert¹,

Werfel²,

Frieling³

et al. 2007

Arch Dermatol

132

100

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To investigate the safety and efficacy of oral methylprednisolone combined with azathioprine sodium or mycophenolate mofetil for the treatment of bullous pemphigoid.Design: A prospective, multicenter, randomized, nonblinded clinical trial to compare 2 parallel groups of patients with bullous pemphigoid undergoing different treatments.Setting: Thirteen departments of dermatology in Germany.Patients: Patients with bullous pemphigoid (n=73) as evidenced by clinical lesions suggestive of bullous pemphigoid, signs of subepidermal blistering on histologic analysis of skin biopsy specimens, linear deposition of IgG and C3 along the dermoepidermal junction, and deposition of autoantibodies at the blister roof in split-skin analysis.Interventions: Treatment with oral methylprednisolone plus azathioprine (azathioprine group) or oral methylprednisolone plus mycophenolate mofetil (mycophenolate mofetil group). Main Outcome Measures:The cumulative total methylprednisolone doses and rates of remission. Secondary outcome measures were safety profiles and duration of remission.

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Section: Commentmentioning

confidence: 99%

A Comparison of Oral Methylprednisolone Plus Azathioprine or Mycophenolate Mofetil for the Treatment of Bullous Pemphigoid

Beissert¹,

Werfel²,

Frieling³

et al. 2007

Arch Dermatol

132

100

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“…6,7 Systemic and potent topical corticosteroids are the primary treatment of BP. 8 Several studies indicate an increase in mortality rates after the diagnosis of BP. The 1-year mortality rate is between 19% and 41% in Europe and between 6% and 12% in the United States.…”

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confidence: 99%

Increased Risk of Stroke in Patients With Bullous Pemphigoid

Yang

Chen

Xirasagar

et al. 2011

Stroke

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Background and Purpose-Although previous research reveals that cardiovascular events and thromboembolic diseases are important causes of death in patients with bullous pemphigoid (BP), the risk of stroke after the diagnosis of BP relative to the general population remains unknown. Using a randomly selected nationwide population-based sample, this study investigates the risk of stroke in patients with BP compared with unaffected individuals of a similar age. Methods-This study analyzes data from Taiwan's National Health Insurance Research Database. This sample included 390 patients with BP and 1950 matched subjects as a comparison group. Stratified Cox proportional hazard regressions were used to calculate the 3-year stroke risk for these 2 groups after adjusting for patient's age, sex, and comorbid medical disorders at baseline. Results-Of the 2340 patients in the sample, 312 patients (13.3%) had strokes during the 3-year follow-up period, 89(22.8% of the patients with BP) in the study group and 223 (11.4% of patients without BP) in the comparison group (PϽ0.001). The hazard ratio for stroke for patients with BP was 2.37 (95% CI, 1.78 to 3.15; PϽ0.001) times as high that for patients without BP within the 3-year follow-up period after adjusting for hypertension, diabetes, hyperlipidemia, heart failure, atrial fibrillation, and coronary heart disease. Conclusions-Patients

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“…Treatment of pemphigus includes systemic glucocorticoids, cyclosporin, azathioprine, cyclophosphamide, gold, and plasmapheresis (27). These immunosuppressive therapies are indispensable, especially for PV, which, unlike PF, can be lifethreatening.…”

Section: Discussionmentioning

confidence: 99%

Thymoma with Pemphigus Foliaceus.

et al. 2000

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A 75-year-old Japanese womanwas referred to us because of an anterior mediastinal mass. Crusts and shallow erosions developed 10 months earlier on her upper chest, back, and scalp. Pemphigus foliaceus was diagnosed based on histological examination of skin biopsy specimens and positivity for serum anti-desmoglein 1 antibody by enzymelinked immunosorbent assay. Neurological examination and electromyography ruled out myasthenia gravis. Total thymectomy was performed, and the postoperative pathology studies showed mixed lymphoepithelial thymoma. One year after the resection, the eruption and alopecia improved and the serum anti-desmoglein 1 antibody titer decreased, suggesting a beneficial effect of thymectomy on thymomarelated pemphigus.

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Management of Acquired Bullous Skin Diseases

Cited by 108 publications

References 112 publications

A Comparison of Oral Methylprednisolone Plus Azathioprine or Mycophenolate Mofetil for the Treatment of Bullous Pemphigoid

A Comparison of Oral Methylprednisolone Plus Azathioprine or Mycophenolate Mofetil for the Treatment of Bullous Pemphigoid

Increased Risk of Stroke in Patients With Bullous Pemphigoid

Thymoma with Pemphigus Foliaceus.

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