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Updated: Jun 20, 2026

Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid

Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid

Published on: June 17, 2025

Rituximab in severe pemphigus.

Enno Schmidt¹, Matthias Goebeler, Detlef Zillikens

¹Department of Dermatology, University of Lübeck, Lübeck, Germany. enno.schmidt@uk-sh.de

Annals of the New York Academy of Sciences

|September 18, 2009

Summary

Rituximab offers a promising treatment for pemphigus, a severe autoimmune blistering disease. This therapy has shown high remission rates and lesion healing in most patients, improving pemphigus management.

Area of Science:

Immunodermatology
Autoimmune Bullous Disorders
Pharmacological Therapies

Background:

Pemphigus is a severe, life-threatening autoimmune blistering disease.
Current treatments, primarily systemic corticosteroids and immunosuppressants, require long-term management.
There is a need for effective therapies for severe and refractory pemphigus cases.

Purpose of the Study:

To review the mechanisms of action of rituximab in pemphigus.
To summarize treatment protocols, clinical responses, and safety profiles of rituximab therapy.
To highlight rituximab as a novel therapeutic option for pemphigus.

Main Methods:

Literature review of published cases (English, French, German) reporting rituximab use in pemphigus.
Analysis of reported clinical outcomes, including remission rates and lesion healing.

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Examination of the safety profile and proposed mechanisms of action.

Main Results:

Rituximab achieved at least partial remission in 95% of 136 reported pemphigus patients.
Complete healing of lesions was observed in approximately two-thirds of treated cases.
A controlled prospective study has recently been initiated.

Conclusions:

Rituximab represents a significant advancement in treating severe and refractory pemphigus.
The drug effectively targets autoreactive B lymphocytes, leading to high rates of remission and healing.
Further investigation through controlled studies is ongoing to confirm efficacy and safety.