Rituximab Therapy of Recalcitrant Bullous Dermatoses

Abstract

Background : Rituximab is a monoclonal antibody directed against CD20 cell surface antigen of B-lymphocytes. Recent studies have demonstrated effectivity in recalcitrant bullous pemphigoid. The data available on other types of autoimmune bullous disease is more scant. Main Observation : Here we report on the successful adjuvant use of rituximab in mucous membrane pemphigoid and pemphigus vulgaris in two patients with the most refractory course of disease. Both patients achieved a good clinical response. Conclusions : Rituximab is a third line treatment of patients with pemphigus vulgaris and mucous membrane pemphigoid. In contrast to bullous pemphigoid, other bullous diseases do not always respond to a monotherapy with this monoclonal antibody. Nevertheless, biological therapy seems to work faster than established treatment in such cases. Risks and benefits of the treatment are discussed.