title: Treatment of refractory pemphigus vulgaris with anti-CD20 monoclonal antibody (rituximab): five cases.
abstract: BACKGROUND
  Pemphigus vulgaris is an autoimmune disease characterized by blisters and widespread erosions, involving skin and mucous membranes, caused by autoantibodies to desmoglein 1 and 3. This pathology is associated with increased morbidity and mortality if untreated. The treatment of pemphigus vulgaris requires multiple immunosuppressive agents, but often it is particularly resistant.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of rituximab therapy in refractory pemphigus vulgaris.
  
  
  METHODS
  Five patients diagnosed as having pemphigus vulgaris were treated with anti-CD20 monoclonal antibody (rituximab). Each patient was treated with rituximab intravenously at a dosage of 375 mg per square metre of body surface area once weekly for 4 weeks.
  
  
  RESULTS
  All the patients presented clinical resolution. No adverse effects were observed. It is important to observe the clinical evolution in the future, but our experience is still limited to a short lifetime and follow-up.
  
  
  CONCLUSIONS
  In our experience rituximab has been an effective and safe treatment for refractory pemphigus vulgaris.
authors.affiliation: Department of Specialistic and Experimental Clinical Medicine, Division of Dermatology, University of Bologna, Bologna, Italy. av_antonucci@yahoo.it
authors.forename: Angela
authors.initials: A
authors.lastname: Antonucci
authors.forename: Massimino
authors.initials: M
authors.lastname: Negosanti
authors.forename: Michela
authors.initials: M
authors.lastname: Tabanelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Varotti
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010392:Pemphigus / Q000188:drug therapy* / Q000473:pathology; D012008:Recurrence; D000069283:Rituximab; D012720:Severity of Illness Index
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000069283:Rituximab