Treatment of subepidermal immunobullous diseases

Abstract

The subepidermal immunobullous diseases are a group of autoimmune blistering disorders of the skin and mucous membranes that share the common features of autoantibody deposition and blister formation at the dermal-epidermal junction or basement membrane. This group includes bullous pemphigoid, linear IgA disease, dermatitis herpetiformis, and epidermolysis bullosa acquisita, among others. Although these disorders share some common features, each disease is unique in its clinical presentation, histopathology, and immunofluorescence patterns, which allows for accurate diagnosis and disease-specific treatment strategy. Treatment of these disorders is complex and requires expert knowledge of disease pathogenesis. We review common treatment approaches for each of these disorders.

RETRACTED: Bullous pemphigoid: Associations and management guidelines

“…Tapering of the dose must be done according to the clinical response of the patients. 33 Due to its minor side effects, we prefer deflazacort at the dose of 60 to 75 mg per day with a lowering of 6 mg every other day.…”

“…33 Severe AZA side effects include leukopenia, thrombocytopenia, anemia, pancytopenia, and hepatotoxicity. Moreover, long-term immunosuppression increases the risk for infections and neoplasia.…”

“…Topical steroids are successful in treating limited or localized BP, but more recent studies have suggested that high-potency topical steroids can also be useful in treating more severe disease. 33 A very well-controlled French multicenter study, comparing topical therapy with 40 g 0.05% clobetasol propionate cream daily to systemic treatment …”

“…Some of these reports have even shown successful control of disease using mycophenolate mofetil as monotherapy in selected patients, although it is usually added to systemic corticosteroids for potential steroid-sparing effect. 33 In adult patients, we use a daily dosage of 1 to 1.5 g in monotherapy.…”

Corticoides tópicos como alternativa terapéutica en la dermatosis ampollosa por inmunoglobulina A lineal de la infancia. Caso clínico

“…1,2,4,15 Sin embargo, en la mayoría de los casos, son usados como terapia adyuvante al inicio del tratamiento, y se utilizan corticoides de alta potencia una o dos veces al día hasta 2 semanas. 2 En nuestro caso, dada la imposibilidad de iniciar el tratamiento con dapsona, se optó por continuar con un tratamiento tópico, que se mantuvo aplicándose a los sucesivos brotes durante 8 semanas hasta conseguir el control de la enfermedad.…”