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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
[Plasma exchange in dermatology: apropos of a case of dermatomyositis]
F Millán Parrilla1, C Pujol Marco, V Oliver Martínez
1Servicio de Dermatología, Hospital General de Valencia.
Abstract:
We present a 45 years old male with dermatomyositis refractory to eight months of standard treatment who responded to plasma exchange. The efficacy of the procedure is estimated from clinical follow-up (increase in strength) and serum creatine-kinase activity (decrease from 3,380 to 44 u/ml.) after five sessions of plasma exchange. The therapeutic indications for PE are reviewed in dermatological diseases with emphasis on cases where the response to steroids or cytotoxic drugs is inadequate.
Insights
Plasma exchange effectively treated a patient with refractory dermatomyositis. This procedure improved muscle strength and reduced creatine kinase levels, offering a new option for difficult cases.
Area of Science:
- Dermatology
- Neurology
- Immunology
Background:
- Dermatomyositis is an idiopathic inflammatory myopathy characterized by muscle weakness and characteristic skin rashes.
- Standard treatments including corticosteroids and cytotoxic drugs are often insufficient for refractory cases.
- Refractory dermatomyositis poses a significant therapeutic challenge, necessitating exploration of alternative treatment modalities.
Observation:
- A 45-year-old male patient presented with dermatomyositis refractory to eight months of standard therapy.
- The patient exhibited significant muscle weakness and elevated serum creatine kinase levels.
- Conventional treatments failed to yield clinical improvement.
Findings:
- Five sessions of plasma exchange resulted in marked clinical improvement, evidenced by increased muscle strength.
- Serum creatine kinase levels decreased dramatically from 3,380 to 44 u/ml following plasma exchange.
- Plasma exchange demonstrated significant efficacy in managing this refractory dermatomyositis case.
Implications:
- Plasma exchange represents a viable therapeutic option for dermatomyositis refractory to standard treatments.
- This case highlights the potential of apheresis techniques in managing complex autoimmune conditions.
- Further research into the role and indications of plasma exchange in dermatological diseases is warranted.
