title: European Guidelines (S1) on the use of high-dose intravenous immunoglobulin in dermatology.
abstract: OBJECTIVE
  Treatment of severe dermatological autoimmune diseases and toxic epidermal necrolysis (TEN) with high-dose intravenous immunoglobulin (IVIg) is a well-established procedure in dermatology. As treatment with IVIg is usually considered for rare clinical entities or severe cases, the use of immunoglobulin is not generally based on data from randomized controlled trials usually required for evidence-based medicine. Since the indications for the use of IVIg are rare, it is unlikely that such studies will be available in the foreseeable future. Because first-line use is limited by the high costs of IVIg, the first clinical guidelines on the use of IVIg in dermatological conditions were established in 2008 and renewed in 2011.
  
  
  METHODS
  The European guidelines presented here were prepared by a panel of experts nominated by the EDF and EADV. The guidelines were developed to update the indications for treatment currently considered effective and to summarize the evidence for the use of IVIg in dermatological autoimmune diseases and TEN.
  
  
  CONCLUSIONS
  The current guidelines represent consensual expert opinions and definitions on the use of IVIg reflecting current published evidence and are intended to serve as a decision-making tool for the use of IVIg in dermatological diseases.
authors.affiliation: Department of Dermatology, Ruprecht-Karls-University Heidelberg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Enk
authors.affiliation: Department of Dermatology, Ruprecht-Karls-University Heidelberg, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Hadaschik
authors.affiliation: Department of Dermatology, Philipps-University Marburg, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Eming
authors.affiliation: Department of Dermatology, Eberhard-Karls-University Tübingen, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Fierlbeck
authors.affiliation: Department of Dermatology, University of Zurich, Switzerland.
authors.forename: Lars
authors.initials: L
authors.lastname: French
authors.affiliation: Department of Dermatology, University of Verona, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Girolomoni
authors.affiliation: Department of Dermatology, Philipps-University Marburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hertl
authors.affiliation: Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jolles
authors.affiliation: Department of Dermatology, Semmelweis University Budapest, Hungary.
authors.forename: Sarolta
authors.initials: S
authors.lastname: Karpati
authors.affiliation: Department of Dermatology, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Steinbrink
authors.affiliation: Department of Dermatology, Medical University of Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Stingl
authors.affiliation: Department of Dermatology, Medical University of Vienna, Austria.
authors.forename: Beatrix
authors.initials: B
authors.lastname: Volc-Platzer
authors.affiliation: Department of Dermatology, University of Lübeck, Germany.
authors.forename: Detlef
authors.initials: D
authors.lastname: Zillikens
mesh_terms: D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000473:pathology; D003880:Dermatology / Q000592:standards*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000592:standards; D019317:Evidence-Based Medicine; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007275:Injections, Intravenous; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy* / Q000473:pathology
chemical_list: D016756:Immunoglobulins, Intravenous