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1. Long-term evaluation of pemphigus vulgaris: A retrospective consideration of 98 patients treated in an oral medicine unit in north-west Italy.

Author

Arduino, Paolo G., Broccoletti, Roberto, Carbone, Mario, Gambino, Alessio, Sciannameo, Veronica, Conrotto, Davide, Cabras, Marco, Sciascia, Savino, Ricceri, Fulvio, Baldovino, Simone, and Carrozzo, Marco

Subjects
*PEMPHIGUS diagnosis, *ORAL medicine, *ORAL manifestations of general diseases, *HEALTH outcome assessment, *AZATHIOPRINE, *RITUXIMAB, *MYCOPHENOLIC acid, *IMMUNOGLOBULINS, *ADRENOCORTICAL hormones, *DIAGNOSIS, *MEDICAL errors, *ORAL diseases, *PEMPHIGUS, *TREATMENT effectiveness, *RETROSPECTIVE studies, *DISEASE complications
Abstract

Background: Despite the frequency of oral involvement, there are unexpectedly few studies of either on the oral manifestations of pemphigus or their long-term management, and diagnostic delay in Dentistry is frequent.Methods: We have examined outcome of patients presenting with predominantly oral pemphigus vulgaris (PV). Ninety-eight subjects were followed up for 85.12 months and treated with systemic steroids: 48 of them received adjunctive therapy with azathioprine, 16 with rituximab, 13 with mycophenolate mofetil, three with immunoglobulin and one with dapsone.Results: Clinical remission was achieved in 80 patients (84.21%); 39 of them were off therapy and 41 on therapy. Fifteen patients were not in remission, having been under systemic therapy for 72.16 months. Sixty-nine patients developed detectable adverse effects. Two fatal outcomes were recorded. Each additional year of steroid therapy ensured 47% chance of developing 1 or 2 side effects, and 64% chance of developing more than 3 (ORs 1.47, CI 1.162-1.903; ORs 1.64, CI 1.107-2.130, respectively).Conclusion: In one of the largest available cohort with the longest follow-up ever reported, we observed that the management remains need-based and patient-specific, still relying on systemic corticosteroids. [ABSTRACT FROM AUTHOR]

Published
2019
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2. Long-term evaluation of pemphigus vulgaris: A retrospective consideration of 98 patients treated in an oral medicine unit in north-west Italy

Author

Davide Conrotto, Mario Carbone, Simone Baldovino, Fulvio Ricceri, Roberto Broccoletti, Marco Cabras, Paolo G. Arduino, Alessio Gambino, Veronica Sciannameo, Savino Sciascia, and Marco Carrozzo

Subjects
Adult, Male, medicine.medical_specialty, Cancer Research, Delayed Diagnosis, pemphigus vulgaris, Azathioprine, oral manifestation, treatment and adverse effects, 2734, Oral Surgery, Otorhinolaryngology, Pathology and Forensic Medicine, Periodontics, Systemic therapy, 03 medical and health sciences, 0302 clinical medicine, Adrenal Cortex Hormones, Internal medicine, medicine, Humans, Adverse effect, Aged, Retrospective Studies, business.industry, Pemphigus vulgaris, Retrospective cohort study, 030206 dentistry, Middle Aged, medicine.disease, Pemphigus, Treatment Outcome, Italy, 030220 oncology & carcinogenesis, Rituximab, Female, business, Mouth Diseases, Oral medicine, medicine.drug
Abstract

BACKGROUND Despite the frequency of oral involvement, there are unexpectedly few studies of either on the oral manifestations of pemphigus or their long-term management, and diagnostic delay in Dentistry is frequent. METHODS We have examined outcome of patients presenting with predominantly oral pemphigus vulgaris (PV). Ninety-eight subjects were followed up for 85.12 months and treated with systemic steroids: 48 of them received adjunctive therapy with azathioprine, 16 with rituximab, 13 with mycophenolate mofetil, three with immunoglobulin and one with dapsone. RESULTS Clinical remission was achieved in 80 patients (84.21%); 39 of them were off therapy and 41 on therapy. Fifteen patients were not in remission, having been under systemic therapy for 72.16 months. Sixty-nine patients developed detectable adverse effects. Two fatal outcomes were recorded. Each additional year of steroid therapy ensured 47% chance of developing 1 or 2 side effects, and 64% chance of developing more than 3 (ORs 1.47, CI 1.162-1.903; ORs 1.64, CI 1.107-2.130, respectively). CONCLUSION In one of the largest available cohort with the longest follow-up ever reported, we observed that the management remains need-based and patient-specific, still relying on systemic corticosteroids.

Published
2019

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