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A 63-year-old man presented with a nine-year history of relapsing pemphigus foliaceus that had become refractory to therapy. After treatment with plasma exchange and oral corticosteroids, his disease flared in association with a rise in antibody titer to 1:1280. Rituximab was administered intravenously at a dose of 800 mg, and the patient was admitted with widespread erythroderma with erosions, scaling, and crusting (Panel A). Despite the administration of intravenous corticosteroids, oral cyclophosphamide, and three additional infusions of rituximab, new lesions continued to develop. Remission was achieved after monthly treatments with high-dose intravenous immune globulin and pulsed intravenous cyclophosphamide over a . . . [Full Text of this Article] |
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