Effectiveness of intravenous immunoglobulin therapy for skin disease other than toxic epidermal necrolysis: A retrospective review of Mayo Clinic experience

• Published in: Mayo Clinic proceedings Vol. 80; no. 1; pp. 41 - 47
• Main Authors: WETTER, David A, DAVIS, Mark Denis P, PITTELKOW, Mark R, YIANNIAS, James A, GIBSON, Lawrence E, DAHL, Mark V, EL-AZHARY, Rokea A, BRUCE, Alison J, LOOKINGBILL, Donald P, AHMED, Iftikhar, SCHROETER, Arnold L
• Format: Journal Article
• Language: English
• Published: Rochester, MN Mayo Medical Ventures 2005; Elsevier Limited
• Subjects: Adolescent; Adult; Biological and medical sciences; Bullous diseases of the skin; Child; Child, Preschool; Dermatology; Dermatomyositis - therapy; General aspects; Humans; Immunoglobulins, Intravenous - adverse effects; Immunoglobulins, Intravenous - therapeutic use; Infant; Infant, Newborn; Male; Medical sciences; Mixed Connective Tissue Disease - therapy; Pemphigoid, Bullous - therapy; Pemphigus - therapy; Retrospective Studies; Skin Diseases, Vesiculobullous - therapy; Urticaria - therapy; Vasculitis, Leukocytoclastic, Cutaneous - therapy; Bullous dermatosis; Medicine; Skin disease; Treatment; Intravenous administration; Erythroderma; Efficiency; Follow up study; Immunotherapy; Lyell syndrome
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/s0025-6196(11)62956-x

To examine retrospectively the use and effectiveness of intravenous immunoglobulin (IVIg) treatment of various skin diseases, primarily immunobullous disease. 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. 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 pemphigoid, 1 complete response (CR) and 2 NR; cicatricial pemphigoid, 1 NR; dermatomyositis, 1 CR and 1 PR; mixed connective tissue disease, 1 CR; chronic urticaria, 1 CR; scleromyxedema, 1 CR; leukocytoclastic vasculitis, 1 PR; and linear IgA bullous disease, 1 CR. Six patients (33%) experienced CR, 3 (17%) had PR, and 9 (50%) had NR to IVIg therapy. All 9 nonresponders were adult patients with immunobullous disease. 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.