Drug-induced pemphigus: A systematic review of 170 patients

Ghaedi, Forugh; Etesami, Ifa; Aryanian, Zeinab; Kalantari, Yasamin; Goodarzi, Azadeh; Teymourpour, Amir; Tavakolpour, Soheil; Mahmoudi, Hamidreza; Daneshpazhooh, Maryam

doi:10.1016/j.intimp.2020.107299

Cited by 30 publications

(28 citation statements)

References 157 publications

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“…Drug-induced pemphigus, which has been reported with penicillamine and captopril, is more likely to be pemphigus foliaceus. In a review of cases of drug-induced pemphigus, ELISA titers were positive for Dsg1 in roughly 70% of cases compared to Dsg3 in roughly 35% [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Differentiating Pemphigus Foliaceus From Pemphigus Vulgaris in Clinical Practice

Stumpf¹,

Huang²,

Hall³

et al. 2021

Cureus

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Pemphigus is a skin condition that causes intraepidermal separation of keratinocytes. Multiple types of pemphigus exist, including pemphigus vulgaris and pemphigus foliaceus. These can be differentiated by histopathology, clinical presentation, appearance of lesions, and antibodies, among other factors. It is important to distinguish between the two because of differences in management and prognosis. Here we present a case of pemphigus foliaceus, as well as a discussion of the key differences between pemphigus foliaceus and vulgaris.

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Section: Discussionmentioning

confidence: 99%

Differentiating Pemphigus Foliaceus From Pemphigus Vulgaris in Clinical Practice

Stumpf¹,

Huang²,

Hall³

et al. 2021

Cureus

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“…Thiol drugs have sulfhydryl (-SH) group in their chemical structure and are probably the better studied group of drugs in the pathogenesis of pemphigus. In a systematic review of 170 drug-induced pemphigus (Ghaedi et al, 2021), penicillamine, captopril and bucillamine, which belong to the thiol drugs, were the most commonly reported drugs to induce pemphigus.…”

Section: Therapeutic Risk Factorsmentioning

confidence: 99%

Autoimmune Pemphigus: Latest Advances and Emerging Therapies

Lim

Bohelay

Hanakawa

et al. 2022

Front. Mol. Biosci.

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Pemphigus represents a group of rare and severe autoimmune intra-epidermal blistering diseases affecting the skin and mucous membranes. These painful and debilitating diseases are driven by the production of autoantibodies that are mainly directed against the desmosomal adhesion proteins, desmoglein 3 (Dsg3) and desmoglein 1 (Dsg1). The search to define underlying triggers for anti-Dsg-antibody production has revealed genetic, environmental, and possible vaccine-driven factors, but our knowledge of the processes underlying disease initiation and pathology remains incomplete. Recent studies point to an important role of T cells in supporting auto-antibody production; yet the involvement of the myeloid compartment remains unexplored. Clinical management of pemphigus is beginning to move away from broad-spectrum immunosuppression and towards B-cell-targeted therapies, which reduce many patients’ symptoms but can have significant side effects. Here, we review the latest developments in our understanding of the predisposing factors/conditions of pemphigus, the underlying pathogenic mechanisms, and new and emerging therapies to treat these devastating diseases.

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“…The phenol group causes acantholysis by participating in the regulation and synthesis of complement and proteases [ 52 ]. A systematic review of 170 patients presenting with drug-induced pemphigus published in 2021 revealed that pemphigus vulgaris (38.9%), pemphigus foliaceus (33.5%), and paraneoplastic pemphigus (3.6%) were the most common subtypes in patients presenting with cutaneous (68.6%), mucocutaneous (30.1%) and mucosal (1.3%) involvement [ 54 ].…”

Section: Non Classical Pemphigus Clinical Variantsmentioning

confidence: 99%

“…The prognosis of drug-induced pemphigus is good, and treatment outcomes are better than in classic pemphigus cases. Almost 90% of patients achieve long-lasting clinical remission [ 54 ]. However, drug-induced pemphigus is a diagnostic challenge; since histopathological and clinical features are identical to idiopathic pemphigus, a thoroughly documented patient history is crucial to timely and adequately identify the causative drug.…”

Section: Non Classical Pemphigus Clinical Variantsmentioning

confidence: 99%

Pemphigus—The Crux of Clinics, Research, and Treatment during the COVID-19 Pandemic

et al. 2021

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Pemphigus is a rare autoimmune disease characterised by the production of pathogenic autoantibodies in response to different desmosome proteins. The pathophysiological process leads to the development of blisters and erosions on mucosal and/or skin surfaces. The classical clinical variants of pemphigus are pemphigus vulgaris and pemphigus foliaceus. A diagnostic delay is very common in pemphigus, especially among patients with mucosal involvement. However, in recent years we have witnessed considerably fewer patients with extensive mucocutaneous manifestations, since patients with oral lesions are referred to dermatologists to start the treatment much sooner than they had been previously. Among non-classical variants of pemphigus, unusual cases with discrepancies between autoantibody profiles and clinics challenge the “desmoglein compensation theory”. The identification of several other autoantigens that perform a role in the pathogenesis of different variants of pemphigus will progress immunodermatology towards an approach that will determine personalized pemphigus subtypes for each patient. Comorbidities among patients are primarily associated with the prolonged use of corticosteroids and other immunosuppressive agents. The SARS-CoV-2 pandemic raised concerns regarding the immunosuppressive effects of treatment and the risk of a more complicated COVID-19 infection, as well as on the ability to develop an adequate vaccine response.

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Drug-induced pemphigus: A systematic review of 170 patients

Cited by 30 publications

References 157 publications

Differentiating Pemphigus Foliaceus From Pemphigus Vulgaris in Clinical Practice

Differentiating Pemphigus Foliaceus From Pemphigus Vulgaris in Clinical Practice

Autoimmune Pemphigus: Latest Advances and Emerging Therapies

Pemphigus—The Crux of Clinics, Research, and Treatment during the COVID-19 Pandemic

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