A case of recalcitrant linear IgA bullous dermatosis: Successfully treated with rituximab

İslamoğlu, Zeynep Gizem Kaya; Akyürek, Fatma Tunçez

doi:10.1111/dth.12911

Cited by 8 publications

(11 citation statements)

References 9 publications

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“…Four articles cite rituximab as an effective additional agent for severe, recalcitrant LAD. Three of the articles used two infusions of 1 g, 2 weeks apart, for two cycles [ 8 , 9 , 12 ]. One used a dosage of 375 mg/m 2 weekly, for a month, with mycophenolate mofetil 500 mg BID (bis in die) after the lack of response to prednisone [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…Monitoring for dapsone adverse reactions can be cumbersome as well. Numerous other treatments have been reported to be effective in the treatment of LAD, including topical corticosteroids, tetracyclines, dicloxacillin, oxacillin, erythromycin, sulfonamides, nicotinamide, rituximab, omalizumab, methotrexate, cyclosporine, etanercept, and intravenous immunoglobulin (IVIg) [1,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. This review provides updates on the diagnosis of LAD and emerging treatment modalities in order to assess their utility in the management of this disease.…”

Section: Introductionmentioning

confidence: 99%

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Updates in the Diagnosis and Management of Linear IgA Disease: A Systematic Review

2021

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Background and Objectives: Linear IgA disease (LAD) is a rare autoimmune blistering disease with linear IgA deposits along the basement membrane zone. Direct immunofluorescence remains the gold standard for diagnosis, but other diagnostic measures reported in recent literature have proven useful in the setting of inconclusive preliminary results. Dapsone is a commonly used treatment, but many therapeutic agents have emerged in recent years. The objective of this study is to provide a comprehensive overview of updates on the diagnosis and management of LAD. Materials and Methods: A literature search was conducted from May to June of 2021 for articles published in the last 5 years that were related to the diagnosis and management of LAD. Results: False-negative results in cases of drug-induced LAD and the presence of IgG and IgM antibodies on immunofluorescence studies were reported. Serration pattern analysis has been reported to be useful in distinguishing LAD from sublamina densa-type LAD. Rituximab, omalizumab, etanercept, IVIg, sulfonamides, topical corticosteroids, and others have been used successfully in adult and pediatric patients with varying disease severity. Topical corticosteroids were preferred for pediatric patients while rituximab and IVIg were used in adults with recalcitrant LAD. Sulfonamides were utilized in places without access to dapsone. Conclusion: In cases where preliminary biopsy results are negative and clinical suspicion is high, repeat biopsy and additional diagnostic studies should be used. Patient factors such as age, medical comorbidities, and disease severity play a role in therapeutic selection.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Updates in the Diagnosis and Management of Linear IgA Disease: A Systematic Review

2021

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“…To the best of our knowledge, only four cases of LABD and one report of an overlap linear IgG/IgA bullous dermatosis case have been successfully treated with rituximab to date (8,9,10,11) . It is a chimeric, anti-CD20 monoclonal antibody currently FDA approved for pemphigus vulgaris among other conditions (11) .…”

Section: Discussionmentioning

confidence: 99%

“…The most effective combination of immunosuppressants with rituximab is unclear. Other LABD cases referenced above were on a multidrug regimen with either corticosteroids, dapsone, MMF, cyclosporine, doxycycline, intravenous immunoglobulin, or a combination of those (8,9,10,11) . Dapsone and MMF were most frequently used.…”

Section: Discussionmentioning

confidence: 99%

Rituximab for linear IgA bullous dermatosis

et al. 2022

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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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“…To date, four cases of linear IgA bullous dermatosis (LABD) and one case of IgA-mediated mucous membrane pemphigoid (IgA-MMP) have been reported as rituximab-treated IgA-mediated AIBD. [3][4][5] Among them, three cases of LABD achieved remission 2-12 months after rituximab treatment, but two other cases did not. He et al 5 showed that IgA + plasmablasts persisted following rituximab therapy in the IgA-MMP case.…”

Section: E 23mentioning

confidence: 99%

Clinical outcome and B‐cell kinetics in intercellular immunoglobulin A dermatosis treated with rituximab

Lee

Ishii

et al. 2021

The Journal of Dermatology

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A case of recalcitrant linear IgA bullous dermatosis: Successfully treated with rituximab

Cited by 8 publications

References 9 publications

Updates in the Diagnosis and Management of Linear IgA Disease: A Systematic Review

Updates in the Diagnosis and Management of Linear IgA Disease: A Systematic Review

Rituximab for linear IgA bullous dermatosis

Clinical outcome and B‐cell kinetics in intercellular immunoglobulin A dermatosis treated with rituximab

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