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Refractory pemphigus foliaceous treated with rituximab
Fatima Awdeh1, Eimear Gilhooley1, Ciara O Grady1
1Dermatology, Tallaght Hospital, Dublin, Ireland.
BMJ Case Reports
|June 1, 2019
Summary
Pemphigus foliaceus, a rare autoimmune skin disease, caused a scalp rash and hair loss in a woman. Treatment with rituximab (anti-CD20 antibody) successfully cleared her skin and regrew her hair.
Area of Science:
- Dermatology
- Immunology
- Autoimmune Diseases
Background:
- Autoimmune blistering diseases, though rare, pose significant health risks.
- Pemphigus foliaceus is characterized by superficial skin erosions without mucosal lesions.
Observation:
- A 57-year-old woman presented with a four-week history of a scalp rash and subsequent hair loss.
- Clinical examination and histopathology confirmed the diagnosis of pemphigus foliaceus.
Findings:
- The patient received rituximab, a monoclonal antibody targeting CD20-positive B cells.
- Successful treatment resulted in complete resolution of the skin rash and full hair regrowth within five months.
Implications:
- Rituximab offers a promising therapeutic option for pemphigus foliaceus, particularly when associated with scalp and hair manifestations.
- This case highlights the potential for B-cell depletion therapy in managing severe autoimmune skin conditions.
- Effective treatment can lead to significant improvements in quality of life, including dermatological and hair restoration.
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