Current and Innovated Managements for Autoimmune Bullous Skin Disorders: An Overview

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Jun 24

PMID 35743598

Authors

Kuan-Yu Chu

Hsin-Su Yu

Sebastian Yu

Affiliations

Soon will be listed here.

Abstract

Autoimmune bullous skin disorders are a group of disorders characterized by the formation of numerous blisters and erosions on the skin and/or the mucosal membrane, arising from autoantibodies against the intercellular adhesion molecules and the structural proteins. They can be classified into intraepithelial or subepithelial autoimmune bullous dermatoses based on the location of the targeted antigens. These dermatoses are extremely debilitating and fatal in certain cases, depending on the degree of cutaneous and mucosal involvement. Effective treatments should be implemented promptly. Glucocorticoids serve as the first-line approach due to their rapid onset of therapeutic effects and remission of the acute phase. Nonetheless, long-term applications may lead to major adverse effects that outweigh the benefits. Hence, other adjuvant therapies are mandatory to minimize the potential harm and ameliorate the quality of life. Herein, we summarize the current therapeutic strategies and introduce promising therapies for intractable autoimmune bullous diseases.

Citing Articles

Successful Treatment of Immune Checkpoint Inhibitor-Induced Bullous Pemphigoid with Omalizumab: A Case Report and Review of the Literature.

Chen J, Xu D, He Z, Ma S, Liu J, Dai X Clin Cosmet Investig Dermatol. 2024; 17:2865-2874.

PMID: 39697463 PMC: 11654213. DOI: 10.2147/CCID.S487711.

Pregabalin-Induced Bullous Pemphigoid: A Case Report of a Rare Drug-Triggered Autoimmune Skin Disorder.

Tovar R, Jones D, Srinivasmurthy R, Pandit M, Ho L Cureus. 2024; 16(9):e69649.

PMID: 39296925 PMC: 11409904. DOI: 10.7759/cureus.69649.

Multifunctional nanoparticle-mediated combining therapy for human diseases.

Li X, Peng X, Zoulikha M, Boafo G, Thapa Magar K, Ju Y Signal Transduct Target Ther. 2023; 9(1):1.

PMID: 38161204 PMC: 10758001. DOI: 10.1038/s41392-023-01668-1.

Necrotizing Fasciitis-Severe Complication of Bullous Pemphigoid: A Systematic Review, Risk Factors, and Treatment Challenges.

Stojicic M, Jurisic M, Marinkovic M, Karamarkovic M, Jovanovic M, Jeremic J Medicina (Kaunas). 2023; 59(4).

PMID: 37109703 PMC: 10144771. DOI: 10.3390/medicina59040745.

Bullous pemphigoid: The role of type 2 inflammation in its pathogenesis and the prospect of targeted therapy.

Zhang L, Chen Z, Wang L, Luo X Front Immunol. 2023; 14:1115083.

PMID: 36875098 PMC: 9978795. DOI: 10.3389/fimmu.2023.1115083.

References

Bishnoi A, De D, Handa S, Mahajan R . Biologics in autoimmune bullous diseases: Current scenario. Indian J Dermatol Venereol Leprol. 2021; 87(5):611-620. DOI: 10.25259/IJDVL_886_19. View

Crofford L, Nyhoff L, Sheehan J, Kendall P . The role of Bruton's tyrosine kinase in autoimmunity and implications for therapy. Expert Rev Clin Immunol. 2016; 12(7):763-73. PMC: 5070917. DOI: 10.1586/1744666X.2016.1152888. View

Didona D, Maglie R, Eming R, Hertl M . Pemphigus: Current and Future Therapeutic Strategies. Front Immunol. 2019; 10:1418. PMC: 6603181. DOI: 10.3389/fimmu.2019.01418. View

Zhao Y, Su H, Shen X, Du J, Zhang X, Zhao Y . The immunological function of CD52 and its targeting in organ transplantation. Inflamm Res. 2017; 66(7):571-578. DOI: 10.1007/s00011-017-1032-8. View

Thorne J, Anhalt G, Jabs D . Mucous membrane pemphigoid and pseudopemphigoid. Ophthalmology. 2004; 111(1):45-52. DOI: 10.1016/j.ophtha.2003.03.001. View

Genovese G, Venegoni L, Fanoni D, Muratori S, Berti E, Marzano A . Linear IgA bullous dermatosis in adults and children: a clinical and immunopathological study of 38 patients. Orphanet J Rare Dis. 2019; 14(1):115. PMC: 6534856. DOI: 10.1186/s13023-019-1089-2. View

Lee A, Sandhu S, Imlay-Gillespie L, Mulligan S, Shumack S . Successful use of Bruton's kinase inhibitor, ibrutinib, to control paraneoplastic pemphigus in a patient with paraneoplastic autoimmune multiorgan syndrome and chronic lymphocytic leukaemia. Australas J Dermatol. 2017; 58(4):e240-e242. DOI: 10.1111/ajd.12615. View

Buch M, Smolen J, Betteridge N, Breedveld F, Burmester G, Dorner T . Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis. Ann Rheum Dis. 2011; 70(6):909-20. PMC: 3086093. DOI: 10.1136/ard.2010.144998. View

Gurcan H, Ahmed A . Current concepts in the treatment of epidermolysis bullosa acquisita. Expert Opin Pharmacother. 2011; 12(8):1259-68. DOI: 10.1517/14656566.2011.549127. View

10.

Kridin K, Ahmed A . Anti-p200 Pemphigoid: A Systematic Review. Front Immunol. 2019; 10:2466. PMC: 6817563. DOI: 10.3389/fimmu.2019.02466. View

11.

Hohwy T, Bang K, Steiniche T, Peterslund N, DAmore F . Alemtuzumab-induced remission of both severe paraneoplastic pemphigus and leukaemic bone marrow infiltration in a case of treatment-resistant B-cell chronic lymphocytic leukaemia. Eur J Haematol. 2004; 73(3):206-9. DOI: 10.1111/j.1600-0609.2004.00280.x. View

12.

van Beek N, Luttmann N, Huebner F, Recke A, Karl I, Schulze F . Correlation of Serum Levels of IgE Autoantibodies Against BP180 With Bullous Pemphigoid Disease Activity. JAMA Dermatol. 2016; 153(1):30-38. DOI: 10.1001/jamadermatol.2016.3357. View

13.

Simon D, Yousefi S, Cazzaniga S, Burgler C, Radonjic S, Houriet C . Mepolizumab failed to affect bullous pemphigoid: A randomized, placebo-controlled, double-blind phase 2 pilot study. Allergy. 2019; 75(3):669-672. DOI: 10.1111/all.13950. View

14.

Saschenbrecker S, Karl I, Komorowski L, Probst C, Dahnrich C, Fechner K . Serological Diagnosis of Autoimmune Bullous Skin Diseases. Front Immunol. 2019; 10:1974. PMC: 6736620. DOI: 10.3389/fimmu.2019.01974. View

15.

Dumas V, Roujeau J, Wolkenstein P, Revuz J, Cosnes A . The treatment of mild pemphigus vulgaris and pemphigus foliaceus with a topical corticosteroid. Br J Dermatol. 1999; 140(6):1127-9. DOI: 10.1046/j.1365-2133.1999.02895.x. View

16.

Eming R, Sticherling M, Hofmann S, Hunzelmann N, Kern J, Kramer H . S2k guidelines for the treatment of pemphigus vulgaris/foliaceus and bullous pemphigoid. J Dtsch Dermatol Ges. 2015; 13(8):833-44. DOI: 10.1111/ddg.12606. View

17.

Hertl M, Jedlickova H, Karpati S, Marinovic B, Uzun S, Yayli S . Pemphigus. S2 Guideline for diagnosis and treatment--guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol. 2014; 29(3):405-14. DOI: 10.1111/jdv.12772. View

18.

Willsteed E, Lee M, Wong L, Cooper A . Sulfasalazine and dermatitis herpetiformis. Australas J Dermatol. 2005; 46(2):101-3. DOI: 10.1111/j.1440-0960.2005.00152.x. View

19.

Heimbach L, Li Z, Berkowitz P, Zhao M, Li N, Rubenstein D . The C5a receptor on mast cells is critical for the autoimmune skin-blistering disease bullous pemphigoid. J Biol Chem. 2011; 286(17):15003-9. PMC: 3083169. DOI: 10.1074/jbc.M111.221036. View

20.

Robak T, Robak E . New anti-CD20 monoclonal antibodies for the treatment of B-cell lymphoid malignancies. BioDrugs. 2010; 25(1):13-25. DOI: 10.2165/11539590-000000000-00000. View