Autoimmune Blistering Diseases, Part II, An Issue of Dermatologic Clinics

Dédée F. Murrell

Description

Part II of Dr. Murrell’s issue devoted to Autoimmune Blistering Diseases focuses on the management of these conditions along with drug treatment, complications, and the treatment of AIBD around the world. Articles include corticosteroid use in AIBD, AIBD management in pregnancy, prevention of opportunistic infections, and therapeutic approaches to patients with mucous membrane pemphigoid, as well as AIBD management in France, Iran, the United States and other countries.

Sujets

• Medical
• Médecine
• Dermatology

Informations

• Publié par: Saunders
• Date de parution: 28 octobre 2011
• Nombre de lectures: 0
• EAN13: 9781455712489
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Dermatologic Clinics , Vol. 29, No. 4, October 2011
ISSN: 0733-8635
doi: 10.1016/S0733-8635(11)00160-4

Contributors
Dermatologic Clinics
Autoimmune Blistering Diseases: Part II - Diagnosis and Management
GUEST EDITOR: Dedee F. Murrell, MA, BMBCh, FAAD, MD, FACD
CONSULTING EDITOR: Bruce H. Thiers, MD
ISSN  0733-8635
Volume 29 • Number 4 • October 2011

Contents
Cover
Contributors
Forthcoming Issues
Autoimmune Blistering Diseases Part II—Diagnosis and Management
Corticosteroid Use in Autoimmune Blistering Diseases
Azathioprine in the Treatment of Autoimmune Blistering Diseases
Mycophenolate Mofetil for the Management of Autoimmune Bullous Diseases
Dapsone in the Management of Autoimmune Bullous Diseases
The Use of Intravenous Immunoglobulin in Autoimmune Bullous Diseases
Rituximab and its Use in Autoimmune Bullous Disorders
Minimizing Complications in Autoimmune Blistering Diseases
Management of Autoimmune Blistering Diseases in Pregnancy
Infection and Infection Prevention in Patients Treated with Immunosuppressive Medications for Autoimmune Bullous Disorders
Evidence-Based Treatments in Pemphigus Vulgaris and Pemphigus Foliaceus
Current Management Strategies in Paraneoplastic Pemphigus (Paraneoplastic Autoimmune Multiorgan Syndrome)
Evidence-Based Management of Bullous Pemphigoid
Pemphigoid Gestationis: Current Management
Management of Linear IgA Disease
Management of Dermatitis Herpetiformis
Therapeutic Approaches to Patients with Mucous Membrane Pemphigoid
Management of Epidermolysis Bullosa Acquisita
Bullous Systemic Lupus Erythematosus
The International Pemphigus and Pemphigoid Foundation
Management of Autoimmune Bullous Diseases in France: A Nationwide Network of 30 Centers
Diagnosis and Treatment of Patients with Autoimmune Bullous Disorders in Germany
Management of Autoimmune Blistering Diseases in Spain
Autoimmune Blistering Diseases: Incidence and Treatment in Croatia
Prevalence and Treatment of Pemphigus in Iran
Pemphigus Treatment in Japan
The Autoimmune Blistering Diseases in Australia: Status and Services
Autoimmune Bullous Diseases in Austria
Treatment of Chronic Bullous Disease of Childhood
Index
Dermatologic Clinics , Vol. 29, No. 4, October 2011
ISSN: 0733-8635
doi: 10.1016/S0733-8635(11)00153-7

Forthcoming Issues
Dermatologic Clinics , Vol. 29, No. 4, October 2011
ISSN: 0733-8635
doi: 10.1016/j.det.2011.07.005

Preface
Autoimmune Blistering Diseases Part II—Diagnosis and Management

Dédée F. Murrell, MA, BMBCh, FAAD, MD, FACD ,
Department of DermatologySt George Hospital, University of New South Wales, Kogarah, Sydney, NSW 2217, Australia
E-mail address: [e-mail]


Dédée F. Murrell, MA, BMBCh, FAAD, MD, FACD, Guest Editor
When invited to edit a special issue of Dermatologic Clinics on Autoimmune Blistering Diseases by Bruce Thiers, I was delighted and honored to accept. I had just finished editing two issues on the genetic blistering disease, Epidermolysis Bullosa, for Dermatologic Clinics and found that the scientific and dermatologic community were keen to contribute to these theme-based issues. There have been a few excellent textbooks devoted to autoimmune blistering diseases (AIBD), with some focusing on the pathology and others on management, but the field is advancing rapidly. There was so much to cover about AIBD that it was decided to cover clinical features, diagnostic testing, and pathogenesis in the first issue and follow it with this issue on management.
Unlike a textbook, where the articles may be over a year or two out of date by the time the book is published, these articles have been written in the last 6 months and by respected leaders in the particular aspects of AIBD. The issue has been organized such that the drugs that are commonly used to treat AIBD are discussed in detail first by dermatologists familiar in their use for AIBD, including Stefan Beissert on azathioprine, Daniel Mimouni on mycophenolate mofetil, Vicky Werth on dapsone, and Pascal Joly on rituximab. This is followed by specific sections on the complications that can result from these treatments and how to manage them, overall by Amit Pandya and specifically on preventing infections by Julia Lehman, Michael Camilleri, and Amer Kalaaji. There is a special article devoted to issues of management of AIBD in pregnancy by Tess McPherson and Vanessa Venning. This is important because the major morbidity and mortality these patients have (apart from risk of blindness in mucous membrane pemphigoid) stem from the treatments themselves. It is not merely a matter of writing a prescription for oral steroids without considering what can be done from baseline to reduce the risks of significant side effects from corticosteroids.
Subsequently, a leading AIBD clinician or team has written about the practical aspects of treating each AIBD, including pemphigus vulgaris and foliaceus, paraneoplastic pemphigus, bullous pemphigoid, mucous membrane pemphigoid, pemphigoid gestationes, linear IgA disease, epidermolysis bullosa acquisita, bullous lupus, and dermatitis herpetiformis. These leaders include Luca Borradori, Russell Hall, Pascal Joly, Sarolta Karpati, Vanessa Venning, and Kim Yancey.
As AIBD are relatively rare skin diseases, it has been difficult to perform randomized controlled trials with sufficient power to demonstrate a statistically significant difference between treatments. To address this, an international group of AIBD experts has developed consensus definitions of the stages in the management of the AIBD and severity scoring systems which have been validated, so that even small clinical trials as well as larger ones can be combined using meta-analysis to determine significance. If we all use the same language and outcome measures in our case reports and case series on AIBD, we will be better able to compare the severity of AIBD patients and their responses to treatment. There are articles detailing the outcome measures of disease extent that have been validated so far as well as studies on quality of life.
Last, we have a section about the services and management of AIBD in various countries and the patient support group, the International Pemphigus and Pemphigoid Foundation. The countries where I could recruit experts willing and able to write about this include Australia, Austria (Martin Laimer, Gabi Pohla-Gubo, Johann Bauer, Helmut Hintner, and colleagues), Croatia (Branka Marinovich and Jasna Lipozencic), France (Nicolas Meyer, Carle Paul, and Pascal Joly), Germany (Enno Schmidt and Detlef Zillikens), Iran (Cheyda Chams Davatchi), Japan (Masa Amagai), and Spain (Ricardo Suárez, Agustín España, and José Mascaró Jr).
Unlike a textbook, these articles can be found on Medline and PubMed and are accessible online. The individual issues of the journal may be purchased for much less cost than either buying a textbook or the articles individually.
The contributors deserve many thanks for their time and effort in writing these articles at relatively short notice and in a succinct manner with excellent color photographs and figures. Inevitably, there are topics and experts whose contributions I would have liked to include but it is difficult for busy clinicians to find extra time to write these articles. On that note, I would particularly like to acknowledge and thank my current and former fellows, Benjamin Daniel, Lizbeth Intong, Linda Martin, and Supriya Venugopal, as well as my former research medical students, Shien-Ning Chee, Andrew Dermawan, John Frew, and Deshan Sebaratnam, who have all been doing projects on AIBD and who have written many of these articles with me. It is good for patients with AIBD if more young dermatologists take an interest in their condition.
Hopefully these two issues will be educational not only for dermatologists but also for all clinicians who interact with patients with AIBD, as well as scientists, family members, and the patients themselves. Understanding what is known so far about a disease leads to improved clinical practice, better research, and improved compliance with therapy.
Dermatologic Clinics , Vol. 29, No. 4, October 2011
ISSN: 0733-8635
doi: 10.1016/j.det.2011.06.004

Corticosteroid Use in Autoimmune Blistering Diseases

John W. Frew, MBBS, MMed (Clin Epi) a , b , Dédée F. Murrell, MA, BMBCh, FAAD, MD, FACD c , *
a St George Hospital, Kogarah, Sydney, NSW 2217, Australia
b Faculty of Medicine, University of Sydney, Sydney, NSW 2006, Australia
c Department of Dermatology, St George Hospital, University of New South Wales, Gray Street, Kogarah, Sydney, NSW 2217, Australia
* Corresponding author.
E-mail address: [e-mail]

Abstract
Corticosteroids, while providing rapid remission and ongoing control of symptoms of autoimmune blistering diseases (AIBD), have numerous potentially serious acute and long-term side effects. Evidence-based medicine has reevaluated the various types of corticosteroids and forms of corticosteroid delivery in AIBD to ascertain whether any advantages of specific delivery systems or regimens exist. Careful monitoring of patients and simple preventive measures are effective in minimizing the adverse outcomes associated with their use. This article outlines the current level of evidence for corticosteroid use in AIBDs, and discusses appropriate investigations and interventions to minimize or prevent the a