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Rachel Laarman, Kimberly A Horii
Pemphigus foliaceus (PF) is an uncommon immunobullous disease in children. Other autoimmune diseases have rarely been reported in children with PF. We report the case of an adolescent girl who presented with concurrent PF and Graves' disease.
December 16, 2016: Pediatric Dermatology
Prajwal Boddu, Mojtaba Nadiri, Owais Malik
Vesiculobullous eruptions in the elderly represent a diverse range of varying pathophysiologies and can present a significant clinical dilemma to the diagnostician. Diagnosis requires a careful review of clinical history, attention to detail on physical and histomorphological examination, and appropriate immunofluorescence testing. We describe the case of a 73-year-old female who presented to our hospital with a painful blistering skin rash developed over 2 days. Examination of the skin was remarkable for numerous flaccid hemorrhagic bullae on a normal-appearing nonerythematous skin involving both the upper and lower extremities...
September 2016: Case Reports in Dermatology
Jonathan L Curry, Michael T Tetzlaff, Priyadharsini Nagarajan, Carol Drucker, Adi Diab, Sharon R Hymes, Madeleine Duvic, Wen-Jen Hwu, Jennifer A Wargo, Carlos A Torres-Cabala, Ronald P Rapini, Victor G Prieto
Immunomodulatory drugs that leverages host immune mechanisms to destroy tumor cells have been met with great promise in the treatment of cancer. Immunotherapy, targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death 1 (PD-1) receptor and its ligand (PD-L1) have shown tremendous improvements in the survival of patients with advanced solid tumors. However, the development of dermatologic toxicity (DT) is a consequence to immunotherapy. Review of published reports of the DT to immunotherapy revealed patients receiving anti-CTCLA-4 antibody or anti-PD-1/PD-L1 antibody often develop a DT of any type and grade...
February 2017: Journal of Cutaneous Pathology
Arpita Sen, Satyendranath Chowdhury, Indrasish Poddar, Debabrata Bandyopadhyay
INTRODUCTION: Dermatology is primarily a non-acute, outpatient-centered clinical specialty, but substantial number of patients need indoor admission for adequate management. Over the years, the need for inpatient facilities in Dermatology has grown manifold; however, these facilities are available only in some tertiary centers. AIMS AND OBJECTIVES: To analyze the characteristics of the diseases and outcomes of patients admitted in the dermatology inpatient Department of a tertiary care facility in eastern India...
September 2016: Indian Journal of Dermatology
Chander Grover, Bineeta Kashyap, Deepashree Daulatabad, Amit Dhawan, Iqbal R Kaur
BACKGROUND: Anti-cyclic citrullinated peptides (CCPs) are autoantibodies directed against citrullinated peptides. Rheumatoid factor (RF), an antibody against the Fc portion of IgG, is known to form immune complexes and contribute to the etiopathogenesis of various skin disorders. C-reactive protein (CRP), an acute-phase protein, increases following secretion of interleukin-6 from macrophages and T cells. Anti-CCP, RF, and CRP are well-established immune-markers, their diagnostic potential in immune-mediated skin disorders remains less widely studied...
September 2016: Indian Journal of Dermatology
Supriya Jain, Vijaya Basavaraj, Manjunath Gubbanna Vimala
OBJECTIVE: Sub-epidermal bullous disorders belong to immunobullous diseases which develop as a result of autoantibody action against epidermal basement membrane proteins. Clinically, they are tense bullae and do not rupture easily. They are classified into various forms based on histopathology and direct immunofluorescence patterns. This study was undertaken to assess the incidence of various sub-epidermal bullous disorders and the utility of direct immunofluorescence in accurately classifying them, and to study the intensity and pattern of immunofluorescence in various sub-epidermal bullous disorders Material and Method: A 2-year study of 38 cases of sub-epidermal bullous disorders sent for direct immunofluorescence studies formed the study group...
2016: Türk Patoloji Dergisi
Harina Vin, Sarah J Seyfer, Colt M McClain, Sylvia Hsu
Pemphigus and pemphigoid are two unique acquired immunobullous diseases with distinct clinical presentations, histological findings, and characteristic serology; they are rarely reported to coexist in the same patient. Herein we present a 29-year-old woman with a history of pemphigus vulgaris, diagnosed by histology and positive desmoglein-3 antibodies on ELISA. She presented to our clinic shortly after the delivery of her first child with tense vesicles and bullae on an erythematous base on her abdomen. Biopsy was consistent with pemphigoid gestationis and direct immunofluorescence confirmed the diagnosis...
January 15, 2016: Dermatology Online Journal
Dipankar De, Geeti Khullar, Sanjeev Handa, Uma Nahar Saikia, Bishan Das Radotra, Biman Saikia, Ranjana W Minz
BACKGROUND: The subepidermal autoimmune bullous diseases are a subset of immunobullous diseases encountered less frequently in the Indian population. There is a paucity of data on the prevalence, demographic and clinicopathological spectrum of various subepidermal autoimmune bullous diseases from India. AIM: To determine the demographic and clinicopathological profile of subepidermal autoimmune bullous diseases in Indian patients, presenting to the Immunobullous Disease Clinic of Postgraduate Institute of Medical Education and Research, Chandigarh...
February 8, 2016: Indian Journal of Dermatology, Venereology and Leprology
Valerie Laniosz, Julia S Lehman, Gregory A Poland, David A Wetter
Autoimmune bullous diseases, such as pemphigus, pemphigoid, and dermatitis herpetiformis, are uniquely associated with vulnerability in the mucocutaneous barrier against infection. The management of immunobullous diseases is complex and may at times require immunosuppressive medications. Iatrogenic immunosuppression may increase susceptibility to vaccine-preventable illnesses. Currently, there are no guidelines to assist the clinician treating patients with immunobullous disease regarding the delivery of various vaccinations...
June 2016: International Journal of Dermatology
Kalyani Marathe, Jun Lu, Kimberly D Morel
Bullous diseases may be rare; however, this does not preclude the clinician from being familiar with their manifestations and treatment. After ruling out infection, genetically inherited blistering diseases are more likely to be the cause of blistering or erosions in the neonatal period, whereas immunobullous diseases are more common in adults. Published literature on immunobullous disorders reflects information gleaned from case reports and open-label case series; prospective studies and evidence-based treatments are limited...
November 2015: Clinics in Dermatology
S Ali, C Kelly, S J Challacombe, A N A Donaldson, J K G Dart, M Gleeson, J F Setterfield
BACKGROUND: Mucous membrane pemphigoid (MMP) is an uncommon mucocutaneous immunobullous disorder. Use of saliva for diagnosis by enzyme-linked immunosorbent assay (ELISA) using the noncollagenous (NC) domain 16a of bullous pemphigoid antigen II (BP180) is not well described. OBJECTIVE: To establish whether whole or parotid saliva is a suitable alternative to serum for diagnosis of MMP. METHODS: Precoated BP180-NC16a ELISA plates were used to test serum, and whole and parotid saliva for IgG, IgA and secretory IgA antibodies...
May 2016: British Journal of Dermatology
Eric Y Sako, Scott Workwick
Pemphigus vulgaris is an immunobullous disease characterized by intraepidermal blister formation. These blisters eventually rupture, leaving erosions that are slow to heal, often leaving hyperpigmented patches, but no scars. We describe a case of a 67- year-old man with pemphigus vulgaris who suffered severe keloidal scarring after the pemphigus lesions became infected. His keloids were treated with intralesional corticosteroids with some improvement. Pemphigus vulgaris, a process confined to the epidermis, may lead to scarring in predisposed individuals, particularly if infection occurs...
November 2015: Dermatology Online Journal
Julia S Lehman, Rokea A el-Azhary
BACKGROUND: Viral superinfection of skin affected by preceding dermatosis has been studied extensively in eczema and reported anecdotally in pemphigus. Little is known about its involvement and complications in patients with other immunobullous diseases. METHODS: To investigate clinical features and complications of viral superinfection in patients with immunobullous diseases, we performed a retrospective chart review. RESULTS: We identified 12 patients with immunobullous diseases (linear immunoglobulin A bullous dermatosis, n = 2; pemphigoid, n = 3; pemphigus, n = 7) and superinfection by herpes simplex virus 1 (n = 9) or 2 (n = 3)...
March 2016: International Journal of Dermatology
J M Thomas, M P Wallace, A Durack, F Kuonen, G Meligonis
No abstract text is available yet for this article.
May 2015: European Journal of Dermatology: EJD
M C Sotiriou, C W Foo, C T Scholes, J J Zone
Cases of immunobullous skin disease associated with ulcerative colitis (UC) have been previously reported in the literature. There is no clear explanation for this association. In this series, we report six cases of immunobullous disease in patients with UC and discuss potential mechanisms of pathogenesis proposed to explain these concomitant diseases. The clinical presentation, immunopathology and treatment of six new cases are described and analysed. We report six patients, two with linear IgA bullous dermatosis (LABD), one with bullous pemphigoid (BP), one with mucous membrane pemphigoid (MMP) and two with IgA pemphigus...
September 2015: British Journal of Dermatology
Yong He, Michiko Shimoda, Yoko Ono, Itzel Bustos Villalobos, Anupam Mitra, Thomas Konia, Sergei A Grando, John J Zone, Emanual Maverakis
IMPORTANCE: Immunobullous diseases mediated by IgA are often difficult to manage, but to date no mechanism has been proposed. Rituximab is an anti-CD20 monoclonal antibody that has demonstrated good efficacy in the treatment of refractory mucous membrane pemphigoid. However, not all cases of mucous membrane pemphigoid respond to rituximab. Herein we present a case of treatment-refractory mucous membrane pemphigoid and propose a mechanism to explain the lack of response to therapy. OBSERVATIONS: Before treatment, direct immunofluorescent examination of a biopsy sample from the patient's perilesional skin demonstrated linear deposition of IgG and IgA along the dermoepidermal junction...
June 2015: JAMA Dermatology
W Alwan, S K Mahil, P Banerjee, O Daramola, A Giles, S Hoque, R Groves
No abstract text is available yet for this article.
December 2015: Clinical and Experimental Dermatology
T Yap, M McCullough
The oral cavity is subject to age related processes such as cellular ageing and immunosenescence. The ageing population bears an increased burden of intraoral pathology. In oral medicine, the majority of presenting patients are in their fifth to seventh decade of life. In this review, we discuss the ageing population's susceptibility to mucosal disorders and the increased prevalence of potentially malignant disorders and oral squamous cell carcinoma, as well as dermatoses including oral lichen planus and immunobullous conditions...
March 2015: Australian Dental Journal
Alireza Ghanadan, Amene Saghazadeh, Maryam Daneshpazhooh, Nima Rezaei
A swift glance at ample evidence currently available about the assay clearly illustrates that the development of direct immunofluorescence (DIF), in which direct fluorescent antibodies are utilized to identify the target antigen, has been of immense importance. The immunoreactant deposits have been delineated by the DIF assay in three main locations, including throughout the epidermis, at the dermoepidermal junction (also known as the basement membrane zone) and in and/or around blood vessel walls. DIF testing can be conducted on several specimen sources, which are categorized according to feasibility of collection into invasive (e...
May 2015: Expert Review of Clinical Immunology
C M Lee, H K Leadbetter, J M Fishman
Objective. Bullous pemphigoid is well known for its cutaneous features; however in rare cases it may present with mucosal involvement. We report a case of bullous pemphigoid presenting with haemoptysis, initially presenting to the Ear, Nose and Throat Department for investigation. Methods. An 87-year-old lady was admitted with haemoptysis. She also complained of a spreading, pruritic, bullous rash, which first began three weeks previously. Initial investigations, which included nasendoscopy, revealed a normal nasal mucosa and a normal postnasal space...
2015: Case Reports in Otolaryngology
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