Psoriasis and bullous pemphigoid treated with azathioprine

Primka, Edward J.; Camisa, Charles

doi:10.1016/s0190-9622(98)70414-1

Cited by 21 publications

(13 citation statements)

References 15 publications

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“…This hypothesis could be supported by the fact that there are barely any cases where appearance of blisters was not directly preceded by psoriasis treatment, excluding topical steroids (5,26). Among anti-psoriatic therapeutics, phototherapy (PUVA) (10)(11)(12)(15)(16)27) and tars (10) are the most common factors suspected for triggering pemphigoid.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, phototherapy as anti-psoriatic therapy is contraindicated because it could exacerbate pemphigoid. Therefore, in the cases of coexistent pemphigoid and psoriasis several different therapeutical schemes encompassing methotrexate (10,14,15), dapson (31), azathioprine (26,27,32), cyclosporine (33,34), erythromycin with etretinate (35), acitretin (36), cyclophosphamide (11) and mycophenolate mofetil (37) have been proposed. We have demonstrated herein that therapy with metotrexate can be an effective therapeutical approach.…”

Section: Discussionmentioning

confidence: 99%

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Coexistence of psoriasis and pemphigoid - only a coincidence?

Łazarczyk

Woźniak²,

Ishii³

et al. 2006

Int J Mol Med

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Abstract. It has previously been reported that pemphigoid coexists with psoriasis more frequently than it could be predicted on the basis of random distribution in the general population. In this study we present three psoriatic patients who developed tense blisters, which most likely were not provoked by anti-psoriatic treatment. Diagnosis of bullous pemphigoid in these cases was established by an overlay antigen mapping technique by laser confocal microscopy, immunoblotting and ELISA. In the context of these cases and the literature, we also discuss possible reasons for the coexistence of psoriasis and pemphigoid as well as selected aspects of diagnosis and therapy of patients simultaneously suffering from these two diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Coexistence of psoriasis and pemphigoid - only a coincidence?

Łazarczyk

Woźniak²,

Ishii³

et al. 2006

Int J Mol Med

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“…As shown in Table III the use of azathioprine has been widely reported for psoriasis, 22,[128][129][130][131][132][133] eczema (atopic dermatitis, hand eczema, adult eczema), 128,134-141 and contact dermatitis. 142,143 Interest in azathioprine for the treatment of psoriasis appears to have waned, but several recent publications have documented its successful use in adult and childhood eczema.…”

Section: Psoriasis and Eczematous Diseasesmentioning

confidence: 99%

Azathioprine in dermatology: The past, the present, and the future

Patel

Swerlick

McCall

2006

Journal of the American Academy of Dermatology

160

136

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“…2 It is suggested that common immune mechanisms may be involved or stimulation in a Koebner phenomenon basis. 3 Mycophenolate mofetil (MMF) is a morpholinoester of mycophenolic acid (MPA) with increased bioavailability, quickly converted to MPA after ingestion. MMF was initially used to prevent acute rejection after renal and cardiac transplantation.…”

Section: Coexistent Psoriasis and Bullous Pemphigoid Responding To Mymentioning

confidence: 99%

Coexistent Psoriasis and Bullous Pemphigoid Responding to Mycophenolate Mofetil Monotherapy

Rallis

Anyfantakis

2008

Skinmed

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A 73-year-old woman with a 50-year history of psoriasis was referred to our clinic with a 4-month duration of tense bullae on erythematous base and erosions localized on her lower extremities and torso (Figure 1A). Neither the oral nor the ocular mucosa had been involved. The lesions were intensively pruritic, significantly affecting the quality of her life. At the time of the examination, the patient presented with psoriatic plaques with adherent scales confined on the scalp (Figure 2A). According to the patient's history, her limited psoriasis was partially controlled with occasional topical medications (topical corticosteroids, calcipotriol, and tar shampoo). She also had insulin-dependent diabetes mellitus, asthmatic bronchitis, and partially controlled hypertension with hyperlipidemia. A biopsy specimen was taken from lesional skin on her feet, and a histological examination showed a subepidermal blister with an inflammatory cell infiltrate in the upper dermis. No drugs were incriminated, and diagnosis of bullous pemphigoid was confirmed by Western immunoblotting of serum. Laboratory investigation revealed mild thrombocytopenia of 110,000/mm(3), cholesterol 279 mg/dL, and triglycerides 210 mg/dL. The patient could not tolerate prednisolone and cyclosporine because of hypertension and diabetes, or azathioprine because of the mild thrombocytopenia; she did not consent to receiving biologics. Mycophenolate mofetil (MMF) was then considered a choice. The patient agreed, and she was initially administered 1000 mg/d. After 2 weeks, the dosage increased to 1000 mg twice a day because of the formation of new blisters. Within 8 weeks of treatment with MMF 2000 mg/d, marked improvement was observed and her pruritus resolved. Complete remission of bullous pemphigoid and psoriasis was achieved within 3 and 4 months, respectively. Routine laboratory studies were performed before treatment and every month during therapy, and MMF was tolerated without side effects. The treatment was continued for 6 months with no subsequent relapse of the dermatoses (Figure 1B and Figure 2B).

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Psoriasis and bullous pemphigoid treated with azathioprine

Cited by 21 publications

References 15 publications

Coexistence of psoriasis and pemphigoid - only a coincidence?

Coexistence of psoriasis and pemphigoid - only a coincidence?

Azathioprine in dermatology: The past, the present, and the future

Coexistent Psoriasis and Bullous Pemphigoid Responding to Mycophenolate Mofetil Monotherapy

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