Use of Intravenous Immunoglobulin in Dermatology

Abstract

Good clinical evidence on the effective use of intravenous immunoglobulin (IVIg) in dermatological conditions can be found as early as 1984 and 1986, when Furusho et al. (1984) and Newburger et al. (1986), respectively, reported the successful application of IVIg in Kawasaki syndrome. Seven years later, Dalakas et al. (1993) reported the first successful randomized controlled trial of IVIg in the treatment of dermatomyositis. Ever since, IVIg has evolved as an important second- and third-line treatment option for severe dermatological conditions like autoimmune blistering diseases and scleromyxedema. Other dermatological conditions that may respond to IVIg treatment include vasculitis and toxic epidermal necrolysis (Table 9.1). Still, IVIg treatment is off-label for most dermatological indications. The most current guidelines on the use of IVIg in dermatology were provided by the European Dermatology Forum in 2016 (Enk et al. 2016). Other comprehensive guidelines on the use of IVIg exist for the United Kingdom (Provan et al. 2008) and Australia (Group NICRW 2012).