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A 52-Year-Old Italian Male with Widespread Blistering and Erosions Refractory to Regular Dose Prednisone

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Abstract

A 52 year-old Australian male of Italian descent began experiencing blisters and erosions on his trunk, face, scalp and mouth in November 2002. Skin biopsy revealed an intraepidermal suprabasal split, and on direct immunofluorescence, IgG and C3 were positive intercellularly in the epidermis. He was admitted to hospital and commenced on 25 mg prednisolone. He discharged himself against medical advice and re-presented at our centre 4 months later in pain with widespread erosions and crusting on his face, scalp, chest, back and mouth, along with hypertension with a blood pressure of 148/118 (Fig. 4.1).

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References

  1. Gupta V, Kelbel T, Nguyen D, Melonakos K, Murrell D, Xie Y, et al. A globally available internet-based patient survey of pemphigus vulgaris: epidemiology and disease characteristics. Dermatol Clin. 2011;29(3):393–404.

    Article  CAS  PubMed  Google Scholar 

  2. Venugopal S, Murrell D. Diagnosis and clinical features of pemphigus vulgaris. Dermatol Clin. 2011;29(3):373–80.

    Article  CAS  PubMed  Google Scholar 

  3. Amagai M, Koch P, Nishikawa T, Stanley J. Pemphigus vulgaris antigen (desmoglein 3) is localized in the lower epidermis, the site of blister formation in patients. J Invest Dermatol. 1996;106(2):351–5.

    Article  CAS  PubMed  Google Scholar 

  4. Ding X, Diaz L, Fairley J, Giudice G, Liu Z. The anti-desmoglein 1 autoantibodies in pemphigus vulgaris sera are pathogenic. J Invest Dermatol. 1999;112(5):739–43.

    Article  CAS  PubMed  Google Scholar 

  5. Chernyavsky A, Arrendondo J, Kitajima Y, Sato-Nagai M, Grando S. Desmoglein versus non-desmoglein signaling in pemphigus acantholysis: characterization of novel signaling pathways downstream of pemphigus vulgaris antigens. J Biol Chem. 2007;282(18):13804–12.

    Article  CAS  PubMed  Google Scholar 

  6. Grando S. Pemphigus autoimmunity: hypotheses and realities. Autoimmunity. 2011;45(1):7–35.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Harman K, Albert S, Black M. Guidelines for the management of pemphigus vulgaris. Br J Dermatol. 2003;149(5):926–37.

    Article  CAS  PubMed  Google Scholar 

  8. Enk A, Knop J. Mycophenolate is effective in the treatment of pemphigus vulgaris. Arch Dermatol. 1999;135(1):54–6.

    Article  CAS  PubMed  Google Scholar 

  9. Mimouni D, Anhalt G, Cummins D, Kouba D, Thorne J, Nousari C. Treatment of pemphigus vulgaris and pemphigus foliaceus with mycophenolate mofetil. Arch Dermatol. 2003;139(6):739–42.

    Article  CAS  PubMed  Google Scholar 

  10. Daniel B, Murrell D, Joly P. Rituximab and its use in autoimmune bullous disorders. Dermatol Clin. 2011;29(4):571–5.

    Article  CAS  PubMed  Google Scholar 

  11. Chams-Davatchi C, Esmaili N, Daneshpazhooh M, Valikhani M, Balighi K, Hallaji Z, et al. Randomized controlled open-label trial of four treatment regimens for pemphigus vulgaris. J Am Acad Dermatol. 2007;57(4):622–8.

    Article  PubMed  Google Scholar 

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Correspondence to Dédée F. Murrell M.A., BMBCh, M.D., FAAD, FACD .

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Maher, N.G., Murrell, D.F. (2015). A 52-Year-Old Italian Male with Widespread Blistering and Erosions Refractory to Regular Dose Prednisone. In: Murrell, D. (eds) Clinical Cases in Autoimmune Blistering Diseases. Clinical Cases in Dermatology, vol 5. Springer, Cham. https://doi.org/10.1007/978-3-319-10148-4_4

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  • DOI: https://doi.org/10.1007/978-3-319-10148-4_4

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