By Lawrence S Chan
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Additional resources for Blistering Skin Diseases
Topically applied medium-strength corticosteroids may also help improve the clinical situation. Interestingly, azithromycine, an oral antibiotic, has been reported to induce disease regression in a patient who has a concurrent urethritis and IgA pemphigus [97a]. Therapeutic strategy Retinoic acid has been used to treat IgA pemphigus successfully . Dapsone also has been shown to be effective . Both retinoic acid and dapsone could be considered as the initial therapeutic regimens, because they have relatively fewer side effects than systemic corticosteroids and immunosuppressive therapy.
On the other hand, when PF autoantibodies target the skin, the presence of desmoglein 3 in the lower epidermis cannot prevent blister formation in the upper epidermis; therefore, a subcorneal blister is observed. However, in neonates, desmoglein 3 is localized in the entire epidermis, thus explaining why babies born to mothers affected by PF do not usually develop skin blisters [70; 74]. The role that anti-desmoglein 1 autoantibodies play in PF is further confirmed by the induction of blisters in newborn mice from IgG passively transferred from PF patients’ sera .
The humanized mouse anti-CD20 antibody, rituximab, has shown great potential in patients with pemphigus vulgaris, and may also be beneficial for patients affected by PH. 32 Laboratory findings Lesional skin biopsy obtained for routine histopathology reveals acantholysis accompanied by variable amounts of inflammatory cell infiltration into the epidermis. The acantholysis occurs mostly at the upper epidermis and the inflammatory cells may be dominated by neutrophils (32), eosinophils, or a mixture of these two cell types [86; 91; 93].
Blistering Skin Diseases by Lawrence S Chan