Foliaceous pemphigus treated with rituximab

Authors

  • Fiorella L. Cardillo Stagno Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina
  • Mónica Persand Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina
  • Rossi Rossi Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina
  • Valeria Taboada Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina
  • Andrea Giuliani Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/da.v28i1.2175

Keywords:

pemphigus, pemphigus foliaceus, seborrheic pemphigus, rituximab, anti-CD20 antibody

Abstract

Pemphigus foliaceus is a rare autoimmune blistering disease, affecting mainly middle-aged adults.
Clinically, squamous plaques with seborrheic distribution are observed. The standard treatment is systemic and immunosuppressive corticosteroids, but due to their adverse effects, anti-CD20 antibodies have been used as first-line therapy in recent years. We present a case of pemphigus foliaceus in a young patient, who evolved to exfoliative erythroderma, in which Rituximab was used as a second-line treatment with excellent evolution.

Author Biographies

Fiorella L. Cardillo Stagno, Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina

Fifth Year Concurrent Doctor

Mónica Persand, Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina

Dermatologist Doctor

Rossi Rossi, Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina

Dermatologist Doctor

Valeria Taboada, Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina

Staff Doctor

Andrea Giuliani, Central Hospital of San Isidro Melchor Angel Posse, Province of Buenos Aires, Argentina

Chief Doctor

References

I. Di Milia MB, Dickson C, Candiz ME, Forero OL, et ál. Guía de manejo de los pénfigos. Sociedad Argentina de Dermatología 2020;1(1). Disponible en: https://sad.org.ar/wp-content/uploads/2020/06/Guias-de-manejo-de-penfigo-2020.-.pdf. [Consultado diciembre 2020].

II. Abdollahimajd F, Shahidi-Dadras M, Robati R, Dadkhahfar S. Management of pemphigus in COVID-19 pandemic era. Arch Acad Emerg Med. 2020;8: e51.

III. Murrell DF, Peña S, Joly P, Marinovic B, et ál. Diagnosis and management of pemphigus: Recommendations of an international panel of experts. J Am Acad Dermatol. 2018;82:575-585.

IV. Cagnolo SA, Sardoy A, Gubiani ML, Boldrini M P, et ál. Pénfigo foliáceo con desafío terapéutico. Rev Argent Dermatol. 2020;101:106-112.

V. Joly P, Maho-Vaillant M, Prost-Squarcioni C, Hebert V, et ál. First-line rituximab combined with short-term prednisone versus prednisone alone for the treatment of pemphigus (Ritux 3): a prospective, multicentre, parallel-group, open-label randomised trial. Lancet. 2017;389:2031-2040.

VI. Rossello VE, Brusa JR, Andrade MN, Alfaro MF, et ál. Pénfigo vulgar refractario a tratamientos convencionales, con respuesta positiva a rituximab: presentación de 5 casos. Rev Argent Dermatol. 2019;100:15-25.

VII. Saleh MA. A prospective study comparing patients with early and late relapsing pemphigus treated with rituximab. J Am Acad Dermatol. 2018;79:97-103.

VIII. Rashid H, Lamberts A, van Maanen D, Bolling MC, et ál. The effectiveness of rituximab in pemphigus and the benefit of additional maintenance infusions: Daily practice data from a retrospective study. J Am Acad Dermatol. 2020;83:1503-1505.

IX. España A, Ornilla E, Panizo C. Rituximab en dermatología. Actas Dermosifiliogr. 2013;104:380-392.

X. Currimbhoy S, Zhu V, Dominguez AR, Pandya AG. Rituximab in the treatment of 38 patients with pemphigus with long-term follow-up. J Eur Acad Dermatol Venereol. 2016;30:1050-1052.

Published

2022-03-22

Issue

Section

Clinical Cases