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Giornale Italiano di Dermatologia e Venereologia 2002 April;137(2):105-15

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Alternative treatments of immunobullous diseases

Lo Schiavo A., Muto L., Ruocco E.

Seconda Università degli Studi - Napoli Facoltà di Medicina e Chirurgia Clinica Dermatologica

For all diseases, dermatological or other, it is idealistic to classify a standard treatment that can be adapted to the clinical varieties of individual pathologies and the subjective conditions of the individual patient. Immunobullous diseases affect a cohort of patients who are heterogeneous for age, sex and race, a fact that often makes the therapeutic management of these patients difficult. In the past, they were associated with a high mortality rate; over the past decades, above all following the introduction of cortisone and immunosuppressive drugs, the prognosis for these pathologies has improved drastically. However, the frequent and numerous collateral effects of cortisone and immunosuppressive drugs in long-term treatment have created new problems, which are often severe and may even be life-threatening. For this reason, other drugs, new therapeutic protocols and adjuvant treatments have flanked conventional treatments over the years, helping to overcome difficult clinical situations. In this review, after a brief summary of the traditional therapeutic protocols, the authors outline some of the alternative drugs and treatment methods used to treat the most frequent immunobullous diseases (bullous pemphigoid, cicatricial pemphigoid, pregnancy pemphigoid, bullous dermatosis with linear IgA, pemphigus). In practice, the optimal target for the physician would be to achieve a pharmacologically-specific and effective treatment with no collateral effects.