Pemphigus vulgaris is an autoimmune blistering disease of the skin and mucous membrane. It is mediated by autoantibody against desmoglein 3, an intracellular adhesion glycoprotein that forms a part of desmosome. Loss of tolerance to this autoantigen happens for a still unknown reason. However, this disease has a very strong association with some human leukocyte antigen molecules whose structure favors the binding of certain peptide of desmoglein 3. The mechanism of the action of autoantibody has turned out to be more complicated than it was thought, and it is not well established yet. Nevertheless, in the past few years, important discoveries have been made that point to a role of autoantibodies in staining different signaling cascades that lead to loss of adhesion between keratinocyte and death of these cells resulting in acantholysis as histologic manifestation and blister as clinical manifestation.
The objective of the study is to compare and evaluate the efficacy of atorvastatin (group -A) versus rosuvastatin (group -B) on baseline parameters like lipid profile tests and to assess the risk of metabolic syndrome using a Mets calculator. A total of 100 patients were enclosed in the present study who met the inclusion criteria. They were divided into two groups based on their treatment plan Group A includes 24 males and 26 females while Group B includes 23 males and 27 females. The mean differences before treatment for group A and group B are as follows, HDL ( 31.52±0.35 and 28.34±0.480), LDL (161.4±1.09 and 163.16±0.94), Total cholesterol (252.82±1.09 and 255.56±1.26) and Triglycerides (214.2±0.86 and 215.98±0.62), VLDL (35.98±0.56 and 36.12±0.43). The mean differences after treatment for group A and group B are as follows HDL (39.92±0.46 and 42.04±0.30), LDL (144.96±0.68 and 138.34±0.73), Total cholesterol (181.48±1.98 vs 174.32±2.08), Triglycerides (185.94±1.22 vs 181.74±1.77), VLDL (27.14±0.21 and 24.72±0.27).Group B (P=0.001) exhibited a significantly greater reduction in cholesterol levels as compared to Group A (P = 0.002). The reductions in LDL, VLDL, Total Cholesterol, and Triglycerides along with increased HDL levels were found to be significantly more in the Rosuvastatin group. In this study, we observed that patients on Rosuvastatin exhibited better control over lipid profile when compared to patients who are on Atorvastatin. Since, this study was conducted on a smaller number of patients, to make consecutive remarks about the superiority of either of the treatment regimen; further analysis of clinical trials is required for appropriate selection of the best statin therapy.
Background: Pemphigus vulgaris (PV) is a rare autoimmune chronic blistering skin disease of type II hypersensitivity reaction.
Case Presentation: The authors present a case of a 42-year-old male with the chief complaint of crusted plaques on face, chest, and scalp for 3 months associated with itching. On investigation, direct immunofluorescence showed immunoglobulin G antibodies. The patient was prescribed antibiotics, anti-inflammatory agents etc., but they did not show any effect. So, the physicians opted for pulse therapy.
Conclusion: PV is a rare chronic ulceration of the mucosa where crusted plaques and blisters are seen. This condition can be effectively resolved using glucocorticoids and immunosuppressant. If untreated, this may lead to the death of the patient.
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