Linear immunoglobulin A (IgA) bullous dermatosis (LABD) is an autoimmune condition with various triggers. Because of the lack of randomized controlled trials on LABD treatment, management options are mostly anecdotal. This paper provides a comprehensive review of treatment options from a literature review of reported treatments to arm clinicians with a guideline for the management of LABD in both pediatric and adult patients as well as those recalcitrant to first-line therapy (dapsone and steroids). We additionally illustrate an algorithm to use for the management of LABD to aid clinicians when faced with unique patient circumstances.
Managing patient expectations can be a difficult task and is one that cosmetic dermatologists frequently encounter. Misinformation and unrealistic expectations can oftentimes exist regarding cosmetic procedures and their results. These misconceptions can result in patient dissatisfaction and frustration on the physician's behalf. This case report underscores the importance of utilizing what is arguably the most basic and ancient tool in the office, the mirror. There are many different facets to the patient encounter and a variety of devices at the physician's disposal. Proper use of this valuable tool can improve communication, elucidate patient concerns, and reflect the focus on the patient. These can ultimately lead to improved procedure outcome and patient satisfaction.
Linear IgA Bullous Dermatosis (LABD) is an idiopathic or drug-induced vesiculobullous disease typically managed with dapsone or colchicine. We report a case of LABD successfully treated with rituximab who was intolerant of first-line therapies and recalcitrant to typical immunosuppressants. The patient was initially started on prednisone and mycophenolate mofetil which resulted in minimal response and disease progression. Improvement was seen after two infusions of rituximab 1000mg at two weeks apart with planned maintenance therapy.
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