EXPLORING THE CLINICAL SPECTRUM AND INDIVIDUALIZED DRUG THERAPY IN PEMPHIGUS VULGAR IS: A CASE SERIES
DOI:
https://doi.org/10.22159/ijpps.2024v16i7.51143Keywords:
Pemphigus, Blister, Oral ulcer, Skin diseases, Mucous membraneAbstract
Pemphigus Vulgaris (PV) is a rare, chronic, life-threatening immunopathogenic disease that is characterized by flaccid, easily ruptured intraepithelial bullae, mostly found on the skin and mucous membranes. Attempting to keep the treatment plan of this potentially deadly disorder in primary focus, we have observed five patients with Pemphigus vulgaris. All patients have been presented with oral lesions or ulcers resulting in difficulty in swallowing. Patient one had a family history of the disease, while the other patients did not present any family history. All five patients had diverse ways of dealing with the disease before getting hospitalized. Microcytic anaemia and hypoalbuminemia have been found in all of them. Patients 1 and 3 had leucocytosis, while patient three had platelets in clumps with Hypercobalaminemia and the presence of ketone bodies in urine analysis. The Desmoglein I and Desmoglein III Antibody along with Punch biopsy results, confirmed the diagnosis. All patients were given systemic corticosteroids on hospitalization, but the case series observed variations in the dosages emphasizing individualized drug therapy. Some developed psychological impairment, some had generalized headaches or cardiac impairment, while ophthalmic involvement was seen in the other patients. Healthcare providers should do close monitoring while providing individualized drug therapy to prevent any systemic involvement and further complications.
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Thanmai JV, Ramlal G, Tejaswi K, Mounica IL. Pemphigus vulgaris: a case report. Pan Afr Med J. 2022 Jul 7;42:184. doi: 10.11604/pamj.2022.42.184.34184, PMID 36212921, PMCID PMC9508361.
Rosi Schumacher M, Baker J, Waris J, Seiffert Sinha K, Sinha AA. Worldwide epidemiologic factors in pemphigus vulgaris and bullous pemphigoid. Front Immunol. 2023 Apr 25;14:1159351. doi: 10.3389/fimmu.2023.1159351, PMID 37180132, PMCID PMC10166872.
Didona D, Paolino G, Di Zenzo G, Didona B, Pampena R, Di Nicola MR. Pemphigus vulgaris: present and future therapeutic strategies. Dermatol Pract Concept. 2022 Jan 1;12(1):e2022037. doi: 10.5826/dpc.1201a37, PMID 35223181, PMCID PMC8824520.
Arpita R, Monica A, Venkatesh N, Atul S, Varun M. Oral pemphigus vulgaris: case report. Ethiop J Health Sci. 2015 Oct;25(4):367-72. PMID 26949302, PMCID PMC4762976.
Malik AM, Tupchong S, Huang S, Are A, Hsu S, Motaparthi K. An updated review of pemphigus diseases. Medicina (Kaunas). 2021 Oct 9;57(10):1080. doi: 10.3390/medicina57101080, PMID 34684117, PMCID PMC8540565.
Pires CA, Viana VB, Araujo FC, Muller SF, Oliveira MS, Carneiro FR. Evaluation of cases of pemphigus vulgaris and pemphigus foliaceus from a reference service in Pará state, Brazil. An Bras Dermatol. 2014 Jul-Aug;89(4):556-61. doi: 10.1590/abd1806-4841.20142679, PMID 25054740, PMCID PMC4148267.
Italiya S, Purohit A, Gohel A, Prajapati H. Histopathological study of non-neoplastic lesions of skin. Asian J Pharm Clin Res. 2022 Sep 7;15(9):180-4. doi: 10.22159/ajpcr.2022.v15i9.45257.
Ljubojevic S, Lipozencic J, Brenner S, Budimcic D. Pemphigus vulgaris: a review of treatment over a 19 y period. J Eur Acad Dermatol Venereol. 2002;16(6):599-603. doi: 10.1046/j.1468-3083.2002.00504.x, PMID 12482043.
Ruocco V, Ruocco E, Lo Schiavo A, Brunetti G, Guerrera LP, Wolf R. Pemphigus: etiology, pathogenesis, and inducing or triggering factors: facts and controversies. Clin Dermatol. 2013;31(4):374-81. doi: 10.1016/j.clindermatol.2013.01.004, PMID 23806154.
Cholera M, Chainani Wu N. Management of pemphigus vulgaris. Adv Ther. 2016 Jun;33(6):910-58. doi: 10.1007/s12325-016-0343-4, PMID 27287854, PMCID PMC4920839.
Sadeghzadeh Bazargan A, Amouzegar A, Abolhasani M, Dehghani A, Goodarzi A, Rahimi ST. Pemphigus vulgaris and focal segmental glomerulosclerosis (FSGS): first reported case and a review of the literature. Clin Case Rep. 2023 Jul 18;11(7):e7716. doi: 10.1002/ccr3.7716, PMID 37476592, PMCID PMC10354356.
Harshita N, Kamath DG, Swati S. Corticosteroids-assets and liabilities on periodontium. Asian J Pharm Clin Res. 2018 May;11(8):56, doi: 10.22159/ajpcr.2018.v11i8.25442.
Tsuruta D, Ishii N, Hashimoto T. Diagnosis and treatment of pemphigus. Immunotherapy. 2012 Jul;4(7):735-45. doi: 10.2217/imt.12.67, PMID 22853759.
Hashimoto T, Kawakami T, Koga H, Ohyama B, Hamada T, Dainichi T. Therapeutic effect of mizoribine on pemphigus vulgaris and pemphigus foliaceus. Dermatol Ther. 2012 Jul-Aug;25(4):382-5. doi: 10.1111/j.1529-8019.2012.01469.x, PMID 22950566.
Lan Y, Zhang H, Jin H. Pregnancy in pemphigus vulgaris: a systematic review. Am J Reprod Immunol. 2024 Jan;91(1):e13813. doi: 10.1111/aji.13813, PMID 38282607.
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