The vesiculobullous reaction pattern

Weedon, David

doi:10.1016/b978-0-7020-3485-5.00007-3

Cited by 31 publications

(40 citation statements)

References 2,186 publications

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“…The fact that PV commonly and initially affects the oral mucosa and then the skin [16], gives dentists a great opportunity to detect the disease at an early stage. The present study showed that 90.4% of the patients had oral mucosal lesions, which is in accordance with a previous report [36]. Moreover, a multicentre study by Brenner et al [37], found varying prevalence of oral lesions in patients with PV; 66% in Bulgarian patients, 83% in Italian, and 92% in Israeli patients.…”

Section: Discussionsupporting

confidence: 93%

“…Our results showed moderate variations in the numbers and means of inflammatory cells from one specimen to another, as well as in the range of cells within one specimen. These results are in consistence with the literature [10]. …”

Section: Discussionsupporting

confidence: 93%

“…In PV, the blisters are located suprabasally, while in PF they are more superficially located. Paraneoplastic pemphigus, although uncommon, is associated with internal malignant neoplasia [10]. …”

Section: Introductionmentioning

confidence: 99%

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Clinical and histological characterization of oral pemphigus lesions in patients with skin diseases: a cross sectional study from Sudan

et al. 2013

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BackgroundPemphigus is a rare group of life-threatening mucocutaneous autoimmune blistering diseases. Frequently, oral lesions precede the cutaneous ones. This study aimed to describe clinical and histological features of oral pemphigus lesions in patients with skin disease has been canceled aged 18 years and above, attending outpatient’s facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. In addition, the study aimed to assess the diagnostic significance of routine histolopathology along with immunohistochemical (IHC) examination of formalin-fixed, paraffin-embedded biopsy specimens in patients with oral pemphigus.MethodsA cross-sectional hospital-based study was conducted from October 2008 to January 2009. A total of 588 patients with confirmed skin has been canceled disease diagnosis completed an oral examination and a personal interview. Clinical evaluations supported with histopathology were the methods of diagnosis. IHC was used to confirm the diagnosis. Location, size, and pain of oral lesions were used to measure the oral disease activity.ResultsTwenty-one patients were diagnosed with pemphigus vulgaris (PV), 19 of them (mean age: 43.0; range: 20–72 yrs) presented with oral manifestations. Pemphigus foliaceus was diagnosed in one patient. In PV, female: male ratio was 1.1:1.0. Buccal mucosa was the most commonly affected site. Exclusive oral lesions were detected in 14.2% (3/21). In patients who experienced both skin and oral lesion during their life time, 50.0% (9/18) had oral mucosa as the initial site of involvement, 33.3% (6/18) had skin as the primary site, and simultaneous involvement of both skin and oral mucosa was reported by 5.5% (1/18). Two patients did not provide information regarding the initial site of involvement. Oral lesion activity score was higher in those who reported to live outside Khartoum state, were outdoor workers, had lower education and belonged to Central and Western tribes compared with their counterparts. Histologically, all tissues except one had suprabasal cleft and acantholytic cells. IHC revealed IgG and C3 intercellularly in the epithelium.ConclusionsPV was the predominating subtype of pemphigus in this study. The majority of patients with PV presented with oral lesions. Clinical and histological pictures of oral PV are in good agreement with the literature. IHC confirmed all diagnoses of PV.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

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Clinical and histological characterization of oral pemphigus lesions in patients with skin diseases: a cross sectional study from Sudan

et al. 2013

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“…They are also found in certain arthropod reactions, particularly in sensitized individuals, and in some bullous drug reactions. [1]…”

mentioning

confidence: 99%

“…[1] Eosinophilic spongiosis has been described as a finding in early urticarial plaques of pemphigoid when the biopsy is taken from an erythematous edematous plaque. [1]…”

mentioning

confidence: 99%

Spongiotic intra-epidermal blister: A pitfall in the histopathologic diagnosis of bullous pemphigoid

Joshi

2013

Indian J Dermatol

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Efficacy and Safety of Guselkumab in Japanese Patients With Palmoplantar Pustulosis

et al. 2019

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IMPORTANCE Palmoplantar pustulosis (PPP) causes erythematous, scaly plaques with recurrent sterile pustules refractory to treatment and with few randomized clinical trials conducted. Evidence points to involvement of interleukin 23 in the pathogenesis of PPP.OBJECTIVE To determine the efficacy and safety of guselkumab, an anti-IL-23 monoclonal antibody, in Japanese patients with PPP. DESIGN, SETTING, AND PARTICIPANTSA phase 3 randomized clinical trial was conducted from December 15, 2015, to December 12, 2017. A total of 159 enrolled patients (aged Ն20 years) had an inadequate response to conventional therapies, with a diagnosis of PPP for 24 or more weeks before screening. Intention-to-treat analysis was performed.INTERVENTIONS Subcutaneous injections of guselkumab, 100 or 200 mg, at weeks 0, 4, and 12, and every 8 weeks thereafter were administered; placebo was given at weeks 0, 4, and 12. MAIN OUTCOMES AND MEASURESChanges from baseline in PPP Area and Severity Index (PPPASI) score (possible score range, 0-72, with higher scores indicating greater area and severity), PPP severity index (PPSI) score (possible score range, 0-12, with higher scores indicating greater severity), and proportion of PPPASI-50 (Ն50% reduction) responders at weeks 16 and 52 were assessed. Safety was monitored through week 52.RESULTS A total of 159 patients (mean [SD] age at diagnosis, 46.8 [11.9] years; 126 women [79.2%]) were enrolled. Treatment groups comprised guselkumab, 100 mg (n = 54), guselkumab, 200 mg (n = 52), or placebo (n = 53). Both guselkumab groups demonstrated significant improvement in least-squares mean changes in PPPASI score compared with placebo: −15.3 and −11.7 in the guselkumab 100-mg and 200-mg groups, respectively, and −7.6 in the placebo group (difference [SE] vs placebo: −7.7 [1.7] in the 100-mg group, P < .001; 95% CI, in the 200-mg group, P < .017; 95% CI, −7.47 to −0.75]). Least-squares mean changes in PPSI score showed significant improvement in both guselkumab groups (100 mg: −2.0 [0.5]; P < .001; 95% CI, −2.96 to −0.95; 200 mg: −1.0 [0.5; P = .04; 95% CI, −2.06 to −0.03). A significantly higher proportion of patients in the guselkumab 100-mg group (31 [57.4%]) achieved a PPPASI-50 response at week 16 vs placebo (18 [34.0%]; P = .02); however, the result was not significant for the guselkumab 200-mg group (19 [36.5%]) vs placebo; P = .78). Each efficacy end point improved consistently through week 52. Health-related quality of life improved significantly as indicated by a reduction in the Dermatology Life Quality Index score (100 mg: −2.6; 95% CI, −4.0 to −1.2; P < .001; 200 mg: −1.6; 95% CI, −3.1 to −0.2; P = .03). Serious treatmentemergent adverse events were observed in 8 patients (placebo group, 2 of 53 [3.8%]; combined guselkumab group, 6/157≠10.5%). No serious infections were reported. CONCLUSIONS AND RELEVANCETargeting interleukin 23 with guselkumab may be an effective and safe treatment option for a recalcitrant disease such as PPP.

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The vesiculobullous reaction pattern

Cited by 31 publications

References 2,186 publications

Clinical and histological characterization of oral pemphigus lesions in patients with skin diseases: a cross sectional study from Sudan

Clinical and histological characterization of oral pemphigus lesions in patients with skin diseases: a cross sectional study from Sudan

Spongiotic intra-epidermal blister: A pitfall in the histopathologic diagnosis of bullous pemphigoid

Efficacy and Safety of Guselkumab in Japanese Patients With Palmoplantar Pustulosis

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