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2006, Number 1

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Rev Hosp M Gea Glz 2006; 7 (1)

Bullous pemphigoid

Vera-Izaguirre DS, Karam-Orantes M, Vega-Memije E

Language: Spanish
References: 29
Page: 27-32
PDF size: 106.65 Kb.


ABSTRACT

Background: Bullous pemphigoid (BP) is an autoimmune bullous disease commonly seen in the elderly. The diagnosis is established in combination of clinical, histologic and immunopathologic features. BP is characterized by the presence of tense bullae arising on normal skin or on an erythematous base, that have a predilection for the extremities and often tends to be generalized. The direct immunofluorescence (IF) studies on perilesional skin reveal linear basement membrane zone (BMZ) deposits of IgG and/or C3. Topical corticosteroids can be used for localized bullous pemphigoid and they may also be considered for generalized pemphigoid. Other immunosuppressive drug therapy is considered for patients who require high maintenance doses of corticosteroid, cases of adverse effects, and for patients whose disease does not respond completely to corticosteroid therapy. The course and prognosis of BP are variable but in general is a self-limiting disease.


REFERENCES

  1. Mutasim DF. Autoimmune bullous dermatoses in the elderly. diagnosis and management. Drugs Aging 2003; 20: 664-78.

  2. Colbert RL, Allen DM, Eastwood D, Fairley JA. Mortality rate of bullous pemphigoid in a US Medical Center. J Invest Dermatol 2004; 122: 1091-95.

  3. Khumalo NP, Wojnarowska F et al. A systematic review of treatments for bullous pemphigoid. Br J Dermatol 2002; 138: 385-89.

  4. Khumalo NP. Management of bullous pemphigoid. recommendations for immunomodulatory treatments. Am J Clin Dermatol 2004; 5: 319-26.

  5. 5 Fitzpatrick’s et al. Dermatology in General Medicine. McGraw-Hill Sixth Edition; Volume I: 574-79.

  6. Bologna JL, Jean L, Jorrizzo JL, Joseph L, Rapini RP. Dermatology Mosby 2003: 463-470.

  7. Sison-Fonacier L, Bystryn JC. Regional variations in antigenic properties of skin: a possible cause for disease-specific distribution of skin lesion. J Exp Med 1986; 164: 2125-30.

  8. Barnhill RL, Crouson AN. Textbook of dermatopathology. McGraw- Hill Second edition. 1998: 181-83.

  9. Mariotti FG, Terracina M, Ruffelli M., Cordiali-Fei P, Sera F, Zambruno G, Mastrogiacomo A, Di Zenzo G. Development of a novel ELISA system for detection of anti-BP 180 IgG and characterization of autoantibody profile in bullous pemphigoid patients. British Journal of Dermatology 2004; 151: 1004-10.

  10. Diaz LA et al. Isolation of a human epidermal cDNA corresponding to the 180-kD autoantigen recognized by bullous pemphigoid and herpes gestations sera. Immunolocalization of this protein to the hemidesmosome. J Clin Invest 1990; 86: 1088-94.

  11. Diya F, Mutasim M. Management of autoinmmune bullous diseases: Pharmacology and therapeutics. J Am Acad Dermatol 2004; 51: 859-877.

  12. Roijeau JP, Benichou J et al. A comparison of oral and topical corticosteroids in patients with bullous pemphigoid. N Engl J Med 2002; 346: 321-27.

  13. Wojnarowska F, Kirtschig G, Highet AS et al. Guidelines for the management of bullous pemphigoid. Br J Dermatol 2002; 147: 214-21.

  14. Eaglitein WH, Siegel J. High-dose methylprednisolone in the treatment of bullous pemphigoid. Arch Dermatol 1984; 120: 1157-65.

  15. Fine JD. Management of acquired bullous skin disease. New Engl J Med 1995; 333: 1475.

  16. Ahmed AR. Azathioprine. Int J Dermatol 1981; 20: 461-69.

  17. Ahmed AR. Cyclophosphamide review of relevant pharmacology and clinical use. J Am Acad Dermatol 1984; 6: 1115-1126.

  18. Thiovolet J, Bartelemy H, Rigot-Muller G et al. Effects of cyclosporine on bullous pemphigoid and pemphigus. Lancet 1985; I: 334-335.

  19. Person JR. Bullous pemphigoid responding to sulfapyridine and the sulfones. Arch Dermatol 1997; 113: 610-615.

  20. Venning VA et al. Dapsone as first line therapy for bullous pemphigoid. Br J Dermatol 1989; 120: 83-87.

  21. Bouscarat F et al. Treatment of bullous pemphigoid with dapsone: retrospective study of thirty-six cases. J Am Acad Dermatol 1996; 34: 686.

  22. Jeffes EW, Ahmed AR. Adjuvant therapy of bullous pemphigoid with dapsone. Clin Exp Dermatol 1991; 25: 691-697.

  23. Goldberg NS, Roenigk Jr HH et al. Plasmapheresis therapy for bullous pemphigoid. Arch Dermatol 1985; 121: 1484-85. 24. Roujeau JC, Guillaune JC, Morel P et al. Plasma ex change in bullous pemphigoid. Lancet 1984; II: 486-89.

  24. Enginneer L, Ahmed AR. Role of intravenous immunoglobulin in the treatment of bullous pemphigoid: analysis of current data. J Am Acad Dermatol 2001; 44: 83-88.

  25. Ahmed AR. Intravenous immunoglobulin therapy for patients with bullous pemphigoid unresponsive to conventional immunosuppressive treatment. J Am Acad Dermatol 2001; 45: 825-35.

  26. Thomas I, Khorenian S, Arbesteld DM. Treatment of generalized bullous pemphigoid with oral tetracycline. J Am Acad Dermatol 1993; 28: 74-77.

  27. Milligan A, Hutchinson P. The use of chlorambucil in the treatment of bullous pemphigoid. J Am Acad Dermatol 1990; 22: 769-01.

  28. Chu J, Bradley M, Marinkovich MP. Topical tacrolimus is a useful adjunctive therapy for bullous pemphigoid. Arch Dermatol 2003; 139: 813-15.

  29. Rzany B, Partscht K, Jung M et al. Risk factors for lethal outcome in patients with bullous pemphigoid. N Engl J Med 2002; 346: 321-27.




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