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- Presentation
Pemphigus and Pemphigoid: Evidence-Based Updates and Practical Clinical Pearls
Description
The session on Pemphigus and Pemphigoid provided comprehensive updates on the clinical presentation, comorbidities, pathophysiology, and treatment options for these autoimmune blistering diseases. Advances in clinical understanding have revealed various presentations, including atypical forms, underscoring the importance of personalized diagnosis. Mental health comorbidities were highlighted, revealing significant rates of anxiety and depression among patients, emphasizing the need for supportive care. Current treatments primarily involve corticosteroids, immunomodulatory agents, and B-cell depleting therapies like rituximab, which has shown efficacy in inducing remission; however, relapses remain common. Emerging therapies, such as FCRN inhibitors and CAR T-cell therapies, are promising for their ability to more effectively target the pathological B cells, potentially offering a rapid onset of action and improved outcomes. The insights shared pointed towards a renaissance in research and treatment approaches in the field, indicating a shift in how pemphigus and pemphigoid might be treated moving forward, alongside a call for early intervention to enhance the chances of successful outcomes for patients.
View moreConclusions
- Blistering diseases like pemphigus and pemphigoid are increasingly understood, with new insights into clinical presentations and management strategies.
- Mental health challenges are significant in patients with pemphigus, highlighting the need for supportive interventions and recognition of psychiatric comorbidities.
- Early diagnosis and treatment of pemphigus significantly improve the likelihood of achieving complete remission with rituximab.
- Emerging therapies, including FcRn inhibitors and CAR T-cell therapy, show promise in targeting autoreactive B cells and improving patient outcomes more rapidly than traditional therapies.
- Factors such as age, disease severity, and timing of treatment initiation can predict relapse and response to rituximab in pemphigus patients.
- Immunomodulatory agents and B cell depletion therapies have been established as critical components in the treatment of pemphigus, with rituximab now preferred in many cases.
- Understanding the evolving pathophysiology and immune mechanisms behind pemphigus can enhance therapeutic approaches and reduce long-term relapses.
- Sciubba JJ. Dent Clin N Am 2011;55:89-103.
- Joly P et al. Clinics in Dermatology 2011;29:432-36.
- James K et al. Dermatologic Clinics 2011;29:405-12.
- Lebeau S et al. Clin Exp Dermatol 2010;35:366-72.
- Tateishi C et al. JAAD 2010;63:e8-10.
- Evans MS et al. Pediatr Dermatol. 2019;36(2):236-41.
- Sanchez-Perez AP et al. Acta Dermatovenerol APA 2021;30:87-88.
- Garg T et al. Indian Dermatol Online J. 2019;10(6):727-9.
- De Almeida et al. Clinics 2006;61:279-82.
- Pourali SP et al. JAMA Dermatol. 2021;157(12):1487-95.
- Patel PM et al. JEADV. 2022;36:e139-41.
- Schultz B et al. Br J Dermatol. 2019;181(5):1101-3.
- Hertl M et al. JEADV 2015;29:405-414.
- Ahmed AR et al. PNAS 2024;121(5):e2317762121.
- Edwards JC and Cambridge G. Nat Rev Immunol 2006;6:394-403.
- Mouquet H et al. J Invest Dermatol. 2008;128:2859-69.
- Tony et al. Arthritis Research & Therapy. 2011;13:R75.
- Balighi K et al. J Dermatol Treat. 2019:30(4):346-349.
- Goebeler M et al. Br J Dermatol 2022;186:429-39.
- Ellebrecht CT et al. Science 2016;353(6295):179-84.
- Lee J et al. J Clin Invest. 2020;130(12):6317-24.
- Joly P et al. Lancet. 2017;389(10083):2031-40.
- Werth V et al. NEJM 2021;384:2295-2305.
- Mignard C et al. JAMA Dermatol. 2020;156(5):1-8.