Longterm clinical remission of oral and cutaneous pemphigus with thalidomide

Lee, Fa-Chyi

doi:10.1111/j.1365-4632.2010.04698.x

Cited by 7 publications

(7 citation statements)

References 20 publications

(18 reference statements)

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“…However, patients with severe PV could also be treated with thalidomide, which has led to longterm clinical remission in previous case reports. 7,8 Most of our patients (5/6) were found to have mucosal involvement. Interestingly, two cases were reported to have mucosal lesions in oral mucosae and/or cervix, and these patients who were resistant to therapy with highdose ster oids responded well to thalidomide started at 100-200 mg/day.…”

Section: Discussionmentioning

confidence: 73%

“…4 However, few case reports of PV treated with tha lidomide have been published. 7,8 Here, we report six PV patients treated with thalidomide -to our knowledge the first and largest case series of patients. Interestingly, these patients were selected for study because of their serious con cerns about corticosteroidsrelated complica tions.…”

Section: Discussionmentioning

confidence: 93%

“…Interestingly, two cases were reported to have mucosal lesions in oral mucosae and/or cervix, and these patients who were resistant to therapy with high-dose ster-oids responded well to thalidomide started at 100–200 mg/day. 7,8 Thalidomide was also reported for the successful management of oral and genital ulcerations in various disorders. 9 Additionally, complete remission was also reported in the control of aphthous stomatitis treated with thalidomide.…”

Section: Discussionmentioning

confidence: 99%

“…One possible mechanism of action is by inhibiting the production of inflammatory cytokines, including tumour necrosis factor-α (TNF-α) and interleukins. 7,11 TNF-α is highly expressed in skin lesions of patients with pemphigus, and serum levels appear to correlate with disease activity. 12 Alternatively, thalidomide could regulate local immunity in the epidermis, which has been shown to play an essential role in pemphigus pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…Several sporadic case reports have also shown that thalidomide could be used for the management of pemphigus, including “Hailey-Hailey pemphigus”, 5 cicatricial pemphigus, 6 and PV. 7,8 In this study, we report six cases of PV patients who refused corticosteroids therapies and other alternative therapies in our clinic due to concerns about the potentially severe adverse effects or complications. This study was approved by the Regional Ethics Committee of the Peking Union Medical University Hospital (approval number: S-K1030).…”

Section: Introductionmentioning

confidence: 99%

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Successful treatment with thalidomide for pemphigus vulgaris

Zhang

Mao

Zhao

et al. 2020

Therapeutic Advances in Chronic Disease

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Background: Pemphigus vulgaris (PV) is a potentially life-threatening mucocutaneous autoimmune blistering disease characterized by suprabasal acantholysis, causing painful mucocutaneous blisters and erosions. Current mainstay therapy for pemphigus is systemic corticosteroids in combination with or without immunosuppressive adjuvants, which may cause severe adverse effects and seriously impact on the quality of life in pemphigus patients. The objective of this study was to evaluate the efficacy and safety of thalidomide therapy in patients with PV. Methods: This study examined six PV patients from June 5, 2017, to November 11, 2018, in the dermatology department of Peking Union Medical College Hospital. Treatment with thalidomide was applied at a dose of 50–100 mg/day for disease control. Results: The mean age of the six patients (two male and four female patients) at the time of thalidomide therapy initiation was 50.2 years (range: 38–67 years), and the total duration of follow-up after thalidomide therapy was 13.2 months (range: 5–25 months). All patients responded favorably to thalidomide treatment, and three patients showed a dramatic reduction in anti-Dsg3 autoantibodies in the serologic examinations within 1 year. Five patients were found to have mucosal involvement. Mild adverse effects were noted in three patients, which could be managed after the application of symptomatic treatment and did not interfere with the pemphigus therapy. Conclusion: These results demonstrate that thalidomide could be an effective and safe option for PV patients, especially those who are concerned about steroid-induced severe complications, and have mucosal diseases.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Successful treatment with thalidomide for pemphigus vulgaris

Zhang

Mao

Zhao

et al. 2020

Therapeutic Advances in Chronic Disease

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Vesiculobullous Dermatoses

Cashman

Doshi

Krishnamurthy

2012

Buka's Emergencies in Dermatology

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Pemphigus

Santoro

Stoopler

Werth

2013

Dental Clinics of North America

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Pemphigus vulgaris and paraneoplastic pemphigus are two subtypes of pemphigus that involve the oral mucosa. These autoimmune blistering disorders have antibodies targeted against proteins of keratinocyte adhesion, thereby causing acantholysis. Clinical findings include oral erosions and flaccid cutaneous bullae and erosions. In addition to the clinical exam, diagnostic tests including tissue biopsy, direct and indirect immunofluorescence, and enzyme-linked immunosorbent assays (ELISA) help to establish a diagnosis. Further malignancy workup in patients with suspected paraneoplastic pemphigus is warranted. Retrospective uncontrolled studies suggest that immunosuppressive agents reduce mortality in pemphigus vulgaris and cohort uncontrolled studies of rituximab, a monoclonal antibody against CD20, suggest it is an effective treatment for refractory patients. Ongoing studies will define its role in early disease.

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Longterm clinical remission of oral and cutaneous pemphigus with thalidomide

Cited by 7 publications

References 20 publications

Successful treatment with thalidomide for pemphigus vulgaris

Successful treatment with thalidomide for pemphigus vulgaris

Vesiculobullous Dermatoses

Pemphigus

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