Effectiveness of Intravenous Immunoglobulin Therapy for Skin Disease Other Than Toxic Epidermal Necrolysis: A Retrospective Review of Mayo Clinic Experience

Wetter, David A.; Davis, Mark Denis P.; Yiannias, James A.; Gibson, Lawrence E.; Dahl, Mark V.; El-Azhary, Rokea A.; Bruce, Alison J.; Lookingbill, Donald P.; Ahmed, Iftikhar; Schroeter, Arnold L.; Pittelkow, Mark R.
January 2005
Mayo Clinic Proceedings;Jan2005, Vol. 80 Issue 1, p41
Academic Journal
OBJECTIVE: To examine retrospectively the use and effectiveness of intravenous Immunoglobulin (IVIg) treatment of various skin diseases, primarily immunobullous disease. PATIENTS AND IVIETHODS: We identified patients who had received IVIg therapy for skin disease between 1996 and 2003 at the Mayo Clinic in Rochester, Minn, Scottsdale. Ariz, and Jacksonville. Fla. and retrospectively reviewed their medical records. RESULTS: Eighteen patients were treated with IVIg for various skin diseases: immunobullous disease in 11 adults (pemphigus vulgaris [7 patients], bullous pemphigold [3], and cicatricial pemphigoid [1]): dermatomyositis (2); mixed connective tissue disease (1): chronic urticaria (1); scleromyxedema (1); leukocytoclastic vasculitis (1); and linear IgA bullous disease (1). Responses of patients by type of disease were as follows: pemphigus vulgaris, 1 partial response (PR) and 6 no response (NR); bullous pemphigold, 1 complete response (CR) and 2 NR; cicatricial pemphigold, 1 NR; dermatomyositis, 1 CR and 1 PR; mixed connective tissue disease, 1 CR; chronic urticaria, 1 CR; sclero-myxedema, 1 CR; leukocytoclastic vasculitis, 1 PR; and linear IgA bullous disease, 1 CR. Six patients (33%) experienced CR, (17%) had PR, and 9 (50%) had NR to IVIg therapy. All 9 non-responders were adult patients with immunobullous disease. CONCLUSION: Although this was a retrospective study of a small cohort of a mixture of patients, the findings emphasize that our experience with IVIg treatment for skin disease, particularly immunobullous disease, is less favorable than that reported previously. Further studies are needed to verify the efficacy of IVIg for skin disease.


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