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- Title
Omalizumab as adjuvant therapy for pemphigus vulgaris.
- Authors
Ji‐Xu, Antonio; Artounian, Kimberly; Fung, Maxwell A.; Le, Stephanie T.; Maverakis, Emanual
- Abstract
Pemphigus vulgaris (PV) is a chronic autoimmune disorder that is frequently refractory and prone to relapse despite immunosuppressive therapy. Although IgG4 autoantibodies to desmogleins are the predominant antibodies in PV pathophysiology, patients with acute PV also exhibit intracellular IgE deposits in the epidermis and significantly higher levels of IgE autoantibodies to DSG3 when compared to those in remission.4 DSG3-specific IgE autoantibodies also correlate strongly with DSG3-specific IgG4 antibodies in acute PV, but not in chronic or remittent patients.4 IgE-mediated mast cell activation leads to cutaneous infiltration and activation of eosinophils in autoimmune bullous diseases.5 PV is also associated with increased levels of mast cells in the skin,5 and spongiosis with a dense eosinophilic infiltrate in the epidermis has been recognized as a pre-acantholytic inflammatory change in this condition.6 Altogether, these findings suggest that IgE autoantibodies constitute a potential therapeutic target in PV. Punch biopsy showed spongiosis with prominent neutrophils and eosinophils centered in the lower epidermis, consistent with PV (Figure 1).
- Publication
Dermatologic Therapy, 2022, Vol 35, Issue 8, p1
- ISSN
1396-0296
- Publication type
Academic Journal
- DOI
10.1111/dth.15646