Antiepiligrin Cicatricial Pemphigoid of the Larynx Successfully Treated With a Combination of Tetracycline and Niacinamide

Abstract

A case of antiepiligrin cicatricial pemphigoid that primarily involved the larynx and required a tracheostomy was studied. The diagnosis was based on the direct immunofluorescence findings of a biopsy specimen from the glottis, immunofluorescence using normal and 1M sodium chloride-split normal human skin as substrates, and immunoprecipitation. A dramatic clinical improvement was observed after the combined administration of tetracycline hydrochloride and niacinamide. The tracheal stoma could be shut after the narrow segment was cut by means of carbon dioxide laser therapy. The patient showed no respiratory difficulty during the 2-year follow-up period. The combined therapy of tetracycline and niacinamide is thus considered to be an effective treatment for various types of cicatricial pemphigoid.

Two Cases of Anti-Epiligrin Cicatricial Pemphigoid With and Without Associated Malignancy

“…Eight patients died from cancer, and 4 ofthe remaining 6 deaths were due to infections that developed during intensive treatment with immunosuppressives. The combined therapy of tetracycline and nicotinamide was reported as an effective treatment for various types of cicatricial pemphigoid (14). Patient 2 in this report, who had no detectable malignancy, was treated successfully with doxycycline and nicotinamide.…”

Laryngeal mucous membrane pemphigoid: A systematic review and pooled‐data analysis

“…The articles identified from our search included 63 case reports7–58 and 10 case series,24, 59–66 representing 141 patients with laryngeal involvement of MMP. No clinical trials or comparative trials of laryngeal MMP were found.…”

Mucous Membrane Pemphigoid

“…91, 92 Nicotinamide is a vitamin B 3 or niacin derivative, usually used at 500–2500 mg/day. Side effects including hepatotoxicity, pruritus, and flushing have been reported at higher doses.…”