Effectiveness of intravenous immunoglobulin therapy for skin disease other than toxic epidermal necrolysis: a retrospective review of Mayo Clinic experience.
OBJECTIVE
To examine retrospectively the use and effectiveness of intravenous immunoglobulin (IVIg) treatment of various skin diseases, primarily immunobullous disease.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Wetter
David A
DA
Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.
Davis
Mark Denis P
MD
Yiannias
James A
JA
Gibson
Lawrence E
LE
Dahl
Mark V
MV
el-Azhary
Rokea A
RA
Bruce
Alison J
AJ
Lookingbill
Donald P
DP
Ahmed
Iftikhar
I
Schroeter
Arnold L
AL
Pittelkow
Mark R
MR
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003882:Dermatomyositis / Q000628:therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008947:Mixed Connective Tissue Disease / Q000628:therapy; D010391:Pemphigoid, Bullous / Q000628:therapy; D010392:Pemphigus / Q000628:therapy; D012189:Retrospective Studies; D012872:Skin Diseases, Vesiculobullous / Q000628:therapy*; D014581:Urticaria / Q000628:therapy; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000628:therapy
D016756:Immunoglobulins, Intravenous