Tetracycline and niacinamide control bullous pemphigoid but not pemphigus foliaceus when these conditions coexist.
Pemphigus and pemphigoid are different types of autoimmune bullous disease and can occur in the same patient. We report a female patient with this condition. At first, we diagnosed her with bullous pemphigoid, and we treated her with tetracycline, niacinamide and a topical steroid. Tense bullas disappeared shortly after that, but crusted erythemas mainly on her head and trunk persisted. We examined BP180 and desmoglein 1 enzyme-linked immunosorbent assays, and also histological features, which showed coexistence of bullous pemphigoid and pemphigus foliaceus concurrently. Therefore, we tried prednisolone, which could control both conditions. This case showed that tetracycline and niacinamide could control bullous pemphigoid, but could not control pemphigus foliaceus, and that prednisolone was effective for both conditions.
Shiohara
Junko
J
Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan. junshio@okaya-hosp.jp
Yoshida
Kanako
K
Hasegawa
Junichi
J
Uhara
Hisashi
H
Takata
Minoru
M
Saida
Toshiaki
T
Ohyama
Bungo
B
Oyama
Bungo
B
Hashimoto
Takashi
T
D001324:Autoantigens / Q000032:analysis; D051183:Desmoglein 1 / Q000032:analysis; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D009536:Niacinamide / Q000627:therapeutic use*; D024041:Non-Fibrillar Collagens / Q000032:analysis; D010391:Pemphigoid, Bullous / Q000188:drug therapy* / Q000473:pathology; D010392:Pemphigus / Q000188:drug therapy* / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*; D013752:Tetracycline / Q000627:therapeutic use*; D000097805:Collagen Type XVII
D001324:Autoantigens; D051183:Desmoglein 1; D009536:Niacinamide; D024041:Non-Fibrillar Collagens; D011239:Prednisolone; D013752:Tetracycline; D000097805:Collagen Type XVII