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Rituximab therapy of recalcitrant bullous dermatoses
Uwe Wollina1, André Koch, Gesina Hansel
1Department of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany.
Background:
Rituximab is a monoclonal antibody directed against CD20 cell surface antigen of B-lymphocytes. Recent studies have demonstrated effectivity in recalcitrant bullous pemphigoid. The data available on other types of autoimmune bullous disease is more scant.
Main Observation:
Here we report on the successful adjuvant use of rituximab in mucous membrane pemphigoid and pemphigus vulgaris in two patients with the most refractory course of disease. Both patients achieved a good clinical response.
Conclusions:
Rituximab is a third line treatment of patients with pemphigus vulgaris and mucous membrane pemphigoid. In contrast to bullous pemphigoid, other bullous diseases do not always respond to a monotherapy with this monoclonal antibody. Nevertheless, biological therapy seems to work faster than established treatment in such cases. Risks and benefits of the treatment are discussed.
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