clobetasol and Autoimmune-Diseases

Linear IgA disease (LAD) is an autoimmune subepidermal blistering disorder characterized by IgA autoantibodies at the dermal-epidermal junction. Conventional first-line treatments include dapsone with or without oral glucocorticosteroids. Various other therapeutic approaches have been used in refractory patients. Immunoadsorption (IA) has been previously successfully applied in severe and/or otherwise treatment-resistant IgG-mediated immunobullous disorders. Here, we report a patient with a severe generalized LAD in whom adjuvant tryptophan IA was associated with rapid healing of skin lesions. Our observation suggests that IA may also be a helpful adjuvant treatment option for severe LAD.

Topics: Adult; Autoimmune Diseases; Blister; Clobetasol; Dapsone; Female; Humans; Immunoglobulin A; Immunosorbent Techniques; Prednisolone; Treatment Outcome; Tryptophan

Cicatricial pemphigoid is at present an incurable, autoimmune disease that involves mucosa and skin. We have documented the clinical, microscopic, and therapeutic features of 23 patients with cicatricial pemphigoid and added these to reports of past literature. The mean age at the time of diagnosis was 63 years, and women were involved twice as often as men. Eighty-three percent of patients had oral mucosal involvement, 70% had conjunctival involvement, and 22% had skin involved. Direct immunologic evaluation revealed IgG at the basement membrane in 57% of cases and C3 in 66%. We have been able to manage the disease adequately in most patients with topical or systemic corticosteroids. The most commonly encountered side effect was oral candidiasis.

Topics: Aged; Autoantibodies; Autoimmune Diseases; Basement Membrane; Clobetasol; Complement C3; Female; Humans; Immunoenzyme Techniques; Immunoglobulin Idiotypes; Male; Middle Aged; Pemphigoid, Benign Mucous Membrane; Prednisone; Retrospective Studies; Sex Ratio; Triamcinolone Acetonide

Cicatricial pemphigoid is at present an incurable, autoimmune disease that involves mucosa and skin. We have documented the clinical, microscopic, and therapeutic features of 23 patients with cicatricial pemphigoid and added these to reports of past literature. The mean age at the time of diagnosis was 63 years, and women were involved twice as often as men. Eighty-three percent of patients had oral mucosal involvement, 70% had conjunctival involvement, and 22% had skin involved. Direct immunologic evaluation revealed IgG at the basement membrane in 57% of cases and C3 in 66%. We have been able to manage the disease adequately in most patients with topical or systemic corticosteroids. The most commonly encountered side effect was oral candidiasis.

Topics: Aged; Autoantibodies; Autoimmune Diseases; Basement Membrane; Clobetasol; Complement C3; Female; Humans; Immunoenzyme Techniques; Immunoglobulin Idiotypes; Male; Middle Aged; Pemphigoid, Benign Mucous Membrane; Prednisone; Retrospective Studies; Sex Ratio; Triamcinolone Acetonide

Topics: Aged; Antibodies, Monoclonal, Murine-Derived; Autoantibodies; Autoimmune Diseases; Clobetasol; Factor VIIa; Factor VIII; Hemophilia A; Hemorrhage; Humans; Immunosuppressive Agents; Male; Methotrexate; Pemphigoid, Bullous; Recombinant Proteins; Rituximab; Treatment Refusal

We sought to describe the response of patients with severe erosive gingival lesions to treatment with clobetasol propionate in Orabase paste administered in trays. The adverse effects were also recorded.. A descriptive pretest/posttest clinical study with no control group (33 patients total) was developed. All patients received repeated applications of 0.05% clobetasol propionate plus 100,000 IU/cc of nystatin in Orabase paste. Over the 48-week period, the pain levels, ulcerations, presence of atrophy, and the patients' daily activities were recorded, and Likert scales were used to classify each outcome as either a complete recovery, excellent, good, poor, or failed. The presence of any adverse effect was also noted.. At the end of the study period, the pain and ulceration had disappeared (complete response) in 100% of the sample (33/33; 95% confidence interval = 89.4%-100%), and there was a complete recovery of daily activities and remission of atrophy in 93.9% (31/33; 95% confidence interval = 79.8%-99.3%) and 21.2% (7/33; 95% confidence interval = 9.0%-38.9%) of the patients, respectively. No adverse effects related to the treatment were observed.. The application of an Orabase paste of 0.05% clobetasol 17-propionate plus 100,000 IU/cc of nystatin by means of a tray appears to be an efficacious treatment for severe erosive gingival lesions.

Topics: Activities of Daily Living; Administration, Topical; Adult; Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Autoimmune Diseases; Clobetasol; Confidence Intervals; Drug Combinations; Female; Follow-Up Studies; Gingival Diseases; Glucocorticoids; Humans; Lichen Planus, Oral; Male; Middle Aged; Nystatin; Pain Measurement; Patient Satisfaction; Pemphigoid, Benign Mucous Membrane; Stomatitis, Aphthous

Desquamation of the gingiva is a sign that may be encountered in clinical practice. Various diseases can affect the gingival tissues. Mild desquamation that is localized may be associated with mechanical irritation or induced by trauma. Moderate to severe generalized desquamation associated with ulceration and erythema may be indicative of a more serious systemic condition. Although often overlooked, mucocutaneous diseases frequently present with gingival desquamation as an early presenting symptom. The most common mucocutaneous diseases that affect the oral cavity are lichen planus, pemphigus, and mucous membrane pemphigoid. This article reviews the etiology, signs and symptoms, and therapies for these disorders. Increased knowledge of mucocutaneous diseases can help the clinician recognize these disorders and enable the patient to receive appropriate therapy.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Autoimmune Diseases; Biopsy; Clobetasol; Dapsone; Diagnosis, Differential; Fluocinonide; Gingivitis; Glucocorticoids; Humans; Immunosuppressive Agents; Lichen Planus, Oral; Pemphigoid, Benign Mucous Membrane; Pemphigus; Prednisone

Topics: Administration, Oral; Administration, Topical; Autoimmune Diseases; Clobetasol; Glucocorticoids; Humans; Pemphigoid, Bullous; Prednisone; Skin Diseases, Vesiculobullous