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At least 145 records · Page 8Linked to original sources
PubMed1989

Kaposi's sarcoma after steroid therapy for pemphigus foliaceus.

A patient with pemphigus foliaceus, derived from pemphigus erythematosus, developed Kaposi's sarcoma characterized by wide-spread skin nodules on the extremities after 5-month treatment with large doses of prednisone. The patient died one year later. We conclude that the immunosuppressive treatment with prolonged large doses of prednisone is attributable to the impairment of cellular immunity and the evolution of Kaposi's sarcoma.

Adult↗
PubMed1998

Treatment of pemphigus: a local experience.

A clinical study was conducted to evaluate the efficacy and safety of three currently used treatment modalities for pemphigus. Seventy-two patients of pemphigus (pemphigus vulgaris and severe cases of pemphigus vegetans, pemphigus foliaceous and pemphigus erythematosus) were divided into three groups. Forty patients were treated with prednisolone, 15 with a combination of prednisolone plus azathioprine and 17 patients with betamethasone-cyclophosphamide pulse (BCP) therapy. All patients were followed from 9 to 21 months (mean 16 months). There was no statistical difference between steroid and azathioprine-corticosteroid therapy groups in terms of time taken to achieve initial control of the disease but the frequency of relapses and the incidence of complications were higher in patients treated with corticosteroids alone (p < 0.05). A marginally increased susceptibility to infections was seen in patients treated with BCP therapy as compared with azathioprine-corticosteroid group (p = 0.07). Seventy percent patients treated with BCP therapy required additional steroids in between the monthly pulses, indicating failure of BCP as sole therapy. It was concluded that azathioprine-corticosteroid treatment of pemphigus was more effective and comparatively safer than steroid alone or BCP therapy.

Anti-Inflammatory Agents↗
PubMed1985

Clinical correlations of antibodies in pemphigus studied by radioimmunoassay.

Pemphigus antibodies of class G immunoglobulins (IgG) were studied with the use of a solid-phase radioimmunoassay (RIA) that utilizes COLO-16, a squamous cell tumor line, as the substrate. Sera from patients with pemphigus vulgaris and pemphigus vegetans showed greater average binding than did sera from patients with pemphigus foliaceus and pemphigus erythematosus. The patients were subgrouped according to their clinical presentations and were divided into patients with skin lesions only, those with mucous membrane lesions only, and those with both skin and mucous membrane lesions. No significant differences were observed between these groups. There was good correlation between IgG binding in the RIA and both the disease activity and the response to therapy. Blood group antigen absorbable "false positive" anti-intercellular substance antibodies were not detected in the RIA.

Animals↗
PubMed1994

Immunopathologic demonstration of MAC387+ UCHL1+ cells in bullous skin diseases.

Immunopathologic aspects of bullous skin diseases were studied in paraffin sections of thirty-three skin biopsy specimens utilizing monoclonal antibodies directed against histiocytes, helper/inducer T lymphocytes, and Langerhans cells in skin lesions. Laboratory examinations revealed that either more or fewer of the standard number of helper/inducer T lymphocytes (UCHL1+) were observed in the upper dermis in 84.8% of the cases examined, particularly in the various forms of pemphigus; histiocytes (MAC387+) were also found to occur in the upper dermis in 45.5% of the cases and blisters in 27.3% of the cases, particularly in pemphigus erythematosus and dermatitis herpetifomis. In 54.5% of all the cases, both UCHL1+ and MAC387+ cell infiltrates predominated in the upper dermis. These findings suggest that a cell-mediated immune response may also be important in the pathogenesis of bullous skin diseases. It may be possible that antigen from keratinocytes can produce ETAF, and that IL1 activating T lymphocytes and histiocytes also produce IL1 activating T cells, particularly helper/inducer T cells. Such activities would further promote the increase of B cell function and immunoglobulin synthesis.

Dermatitis Herpetiformis↗
PubMed1975

[Autoimmune phenomena in D-penicillamine therapy].

In two patients with rheumatoid arthritis, immunoglobuline deposits in the skin were detected during D-penicillamine treatment. One patient presented with drug induced exanthema, the other with pemphigus erythematosus which was confirmed by clinical, histological, and immunofluorescent findings. During the development of the specific side-effect in one patient, an increase of ANA-titre and antibody-binding-capacity versus denaturated DNA was observed. Therefore in a prospective study of another ten patients during four months after onset of treatment with D-penicillamine, antinuclear antibodies and antibody-binding-capacity versus native and denaturated DNA were examined. The latter group of patients - without skin lesions - did not show any changes in the above mentioned parameters.

Antibodies, Antinuclear↗
PubMedDate not supplied

[Fatal "overwhelming" strongyloidiasis in an immunosuppressed patient].

The increased use of immunosuppressants in the treatment of malignant and non-malignant diseases in today's medicine has significantly contributed to the increased interest in infections caused by opportunistic microorganisms and rare parasites. A fifty-eight-year old male patient, professor, born in Bosnia, was admitted to the Institute due to poor general condition and decompensated steroid diabetes. He had been under immunosuppressant therapy for the previous 5 weeks. Six months before, he noticed squamous and crusted changes on capilli, and afterwards on his body too. As these changes did not respond to local therapy he was admitted to the Department of Dermatovenereology, Zagreb University School of Medicine. Histologic analysis indicated pemphigus erythematosus. He was treated with immunosuppressants (methylprednisolone + azathioprine). Endoscopic examinations revealed duodenal ulcer, in addition to diabetes which could not be regulated by oral hypoglycemics. He received antiulcerative therapy for ulcer treatment. Several hours upon admission the patient became highly febrile, and vomited a sanguinolent content. In spite of intensive therapy, he became comatose and died 20 hours later. On autopsy, generalized strongyloidosis of the lungs, liver, duodenum and small intestine, and a bleeding duodenal ulcer due to strongyloidosis were found. This review should remind us that hyperinfestation with strongyloides is a rare and severe complication, and could be expected in immunocompromised patients.

Animals↗
PubMed1991

Treatment of pemphigus.

Ninety-eight cases of various types of pemphigus were treated between 1978-1987. Sixty-one cases were pemphigus vulgaris (PV), 22 cases were pemphigus foliaceus, generalized type (PFG) in which one case developed pemphigus vegetans, 11 cases were pemphigus foliaceus localized type (PFL), and four cases were pemphigus erythematosus (PE). Fifteen mild cases of PV and three mild PFG were treated with corticosteroid (prednisolone or prednisone) alone, and dapsone or cyclophosphamide (CP) were added as treatment failed in two cases of each. Dapsone alone was used effectively in three cases of mild PV. Eight cases of moderate and three cases of severe PV, as well as five cases of moderate PFG, failed to respond to corticosteroid alone but were cleared by the addition of CP. Thirty-two moderate cases of PV and PFG treated with a combination of corticosteroid 60 mg/day plus initial CP and 14 severe cases of PV and PFG treated with corticosteroid 120 mg/day plus initial CP, resulted in clearing skin lesions in 2 months. Azathioprine or chlorambucil were substituted in three cases who developed CP toxicity. Addition of gold sodiumthiomalate in six refractory cases when the above regimens failed, caused a complete remission in two and partial control in four. Higher dosage of prednisolone or prednisone more than 120 mg/day has never been used. Eleven cases of PFL and four cases of PE were treated with uneventfully good results. Intercellular antibody titers became negative within 4.67 months except in refractory cases, however, the treatment was continued for at least 3 years. Herpes simplex superimposed infection was more common than herpes zoster infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Pulse corticosteroid therapy with methylprednisolone or dexamethasone.

Intravenous pulse steroid therapy consists of administration of supraphysiological doses of glucocorticoids. It is useful in conditions where rapid immunosuppression and antiinflammatory effect is desired, as in systemic lupus erythematosus, pemphigus, renal transplantation, steroid resistant nephrotic syndrome and crescentic glomerulonephritis. This therapy may be associated with significant adverse reactions including hypertension, arrhythmias, hypokalemia, psychosis and infections. High dose steroid therapy should therefore be used in selected cases and under careful supervision. The drug most widely used for this treatment is methylprednisolone. However, in view of its easy availability and cost, dexamethasone has been often used in India for the above conditions. While there are no controlled studies comparing the two drugs, it appears that the two drugs may be similar in efficacy. Patients requiring high dose intravenous steroid therapy may be treated effectively with either methylprednisolone or dexamethasone.

Anti-Inflammatory Agents↗
PubMedDate not supplied

Pancytopenia induced by low-dose methotrexate. A study of the cases reported to the Finnish Adverse Drug Reaction Register From 1991 to 1999.

OBJECTIVE: To study cases of low-dose methotrexate-induced pancytopenia with special reference to clinical outcome and factors predisposing to bone marrow suppression. METHODS: Patient files of 14 cases of methotrexate-induced pancytopenia reported to the National Agency for Medicines in Finland from 1991 to 1999 were reviewed. A review of four additional cases was included. RESULTS: Of the 18 patients (median age 72 years), 12 had rheumatoid arthritis, one psoriatic arthritis, five psoriasis without arthritis, and one pemphigus erythematosus. Major co-morbidity was recorded in 12 patients, and 16 patients used significant concomitant drugs. Eight patients had a mildly or moderately elevated serum creatinine concentration. In every patient the occurrence of cytopenia was abrupt. Eight patients (44%) died, and the most frequent cause of death was infection. CONCLUSIONS: Our data show that methotrexate-induced pancytopenia is associated with high mortality especially in cases with significant co-morbidity and concomitant medications.

Adverse Drug Reaction Reporting Systems↗
PubMed1978

[Are antinuclear factors a contraindication for penicillamine treatment in patients with rheumatoid arthritis? (author's transl)].

28 patients with rheumatoid arthritis undergoing treatment with penicillamine were investigated over a period of 7 to 72 months. Antinuclear antibodies were detected in 43% of patients before treatment, and 39% when treatment was completed. In all patients anti-native DNA antibodies were within the normal range. Precipitating antibodies to heat-denatured DNA were detected in 3 out of 16 patients at the end of therapy. There was no correlation between the detection of antinuclear antibodies, antibodies to native or denatured DNA and the occurrence of immunological side effects due to penicillamine (1 patient with pemphigus erythematosus, 3 patients with immune-complex nephritis).

Antibodies, Antinuclear↗
PubMed1980

[Seborrheic pemphigoid (Schnyder)].

Seborrheic pemphigoid first described by Schnyder is considered to be a clinical variant of bullous pemphigoid which resembles pemphigus erythematosus. Ruptured bullae and erosions covered with crusts involving predominantly the median parts of the trunc characterize the clinical picture. Histologic and immunofluorescence findings substantiate the diagnosis of pemphigoid. The clinical, histopathologic and immunofluorescence features as well as the course of the disease in a 74 year old woman are described.

Aged↗
PubMed1981

Sacroiliac joints in chronic dermatoses.

In 34 patients with different chronic skin diseases (including eczemas, lichen ruber, erythrodermia, pyodermia, pemphigus erythematosus, vasculitis, parapsoriasis varioliformis, scleroderma adultorum Buschke, prophyria cutanea tarda, rosacea, dermatomyositis, erythematodes chronicus discoides and indurative tuberculosis), X-ray studies revealed sacroiliac-changes consistent with a low-grade inflammation. This oteoarthritis slightly differs from the patterns disclosed earlier by the same authors in psoriatic patients, lacking any clinical bone or joint symptoms. So far, it has not been possible to explain their nature, cause or development.

Adult↗