Skip to main content

Therapeutic aspects of autoimmune diseases of the skin

  • Chapter
Treatment of Autoimmune Disorders
  • 123 Accesses

Abstract

The skin represents the largest and at the same time most exposed organ of the human body. Apart from infectious, inflammatory, and neoplastic conditions it can be involved by autoimmune reactions as well. These may result in distinct clinical entities where the skin is the main or only target as found among autoimmune bullous skin diseases. In contrast, skin symptoms are seen as one of several disease manifestations in the context of collagenoses which represent multiorgan diseases. A third group of skin manifestations presents with uncharacteristic symptoms which simply reflect autoimmune diseases of internal organs (Table 1).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Ahmed AR (2001) Intravenous immunoglobulin therapy for patients with bullous pemphigoid unresponsive to conventional immunosuppressive treatment. J Am Acad Dermatol 45: 825–835

    Article  PubMed  CAS  Google Scholar 

  • Altmeyer P, Matthes U, Pawlak F, Hoffmann K, Frosch PJ, Ruppert P (1994) Antipsoriatic effect of fumaric acid derivatives: results of a multicenter double-blind study in 100 patients. J Am Acad Dermatol 30:977–981

    Article  PubMed  CAS  Google Scholar 

  • Ameen M, Exarchou V, Chu AC (2001) Topical calcipotriol as monotherapy and in combination with psoralen plus ultraviolet A in the treatment of vitiligo. Br J Dermatol 145: 476–479

    Article  PubMed  CAS  Google Scholar 

  • Anstey A (1996) Management of immunobullous disorders: the clinical significance of interindividual variation in azathioprine metabolism. Clin Exp Dermatol 21: 247–248

    Article  PubMed  CAS  Google Scholar 

  • Becker L, Bastian B, Wesselmann U, Karl S, Hamm H, Brocker EB (1998) Paraneoplastic pemphigus treated with dexamethasone/cyclophosphamide pulse therapy. Eur J Dermatol 8: 551–553

    PubMed  CAS  Google Scholar 

  • Bodemer C, Teillac D, Le Bourgeois M, Wechsler B, de Prost Y (1990) Efficacy of intravenous immun-globulins in sclerodermatomyositis. Br J Dermatol 123: 545–546

    Article  PubMed  CAS  Google Scholar 

  • Bornhovd E, Burgdorf WH, Wollenberg A (2001) Macrolactam immunomodulators for topical treatment of inflammatory skin diseases. J Am Acad Dermatol 45: 736–743

    Article  PubMed  CAS  Google Scholar 

  • Bottomley WW, Goodfield MJ (1995) Methotrexate for the treatment of discoid lupus erythematosus. Br J Dermatol 133: 655–656

    Article  PubMed  CAS  Google Scholar 

  • Burt RK, Slavin S, Burns WH, Marmont AM (2002) Induction of tolerance in autoimmune diseases by hematopoietic stem cell transplantation: getting closer to a cure? Blood 99: 768–784

    Article  PubMed  CAS  Google Scholar 

  • Cronstein BN (1996) Molecular therapeutics: methotrexate and its mechanism of action. Arthritis Rheum 39:1951–1960

    Article  PubMed  CAS  Google Scholar 

  • Dalakas MC (1999) Intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: present status and practical therapeutic guidelines. Muscle Nerve 22: 1479–1497

    Article  PubMed  CAS  Google Scholar 

  • De Vita S, Ferraccioli GF, Di Poi E, Bartoli E, Bombardieri S (1996) High dose intravenous immunoglobulin therapy for rheumatic diseases: clinical relevance and personal experience. Clin Exp Rheumatol 14: S85–S92

    PubMed  Google Scholar 

  • Dutz JP, Ho VC (1998) Immunosuppressive agents in dermatology: an update. Dermatol Clin 16: 235–251

    PubMed  CAS  Google Scholar 

  • Edwards KR, Burke WA (1999) Treatment of localized discoid lupus erythematosus with tazarotene. J Am Acad Dermatol 41: 1049–1050

    Article  PubMed  CAS  Google Scholar 

  • Ermis O, Alpsoy LC, Yilmaz E (2001) Is the efficacy of psoralen plus ultraviolet A therapy for vitiligo enhanced by concurrent topical calcipotriol? A placebo-controlled double-blind study. Br J Dermatol 145: 472–475

    Article  PubMed  CAS  Google Scholar 

  • Fleischli ME, Rachel H, Valek BS, Pandya AG (1999) Pulse intravenous cyclophosphamide therapy in pemphigus. Arch Dermatol 135: 57–61

    Article  PubMed  CAS  Google Scholar 

  • Furst DE (1999) Leflunomide, mycophenolic acid and matrix metalloproteinase inhibitors. Rheumatology (Oxford) 38: 14–18

    Article  CAS  Google Scholar 

  • Gasparro FP (2000) Photodermatology: progress, problems and prospects. Eur J Dermatol 10: 250–254

    PubMed  CAS  Google Scholar 

  • Gelfand Erwin W (2001) Antibody-directed therapy: past, present and future. J Allergy Clin Immunol 108: 111–116

    Article  Google Scholar 

  • Genant HK, Cooper C, Poor G, Reid I, Ehrlich G, Kanis J, Nordin BE, Barrett-Connor E, Black D, Bonjour JP, Dawson-Hughes B, Delmas PD, Dequeker J, Ragi Eis S, Gennari C, Johnell 0, Johnston CC Jr, Lau EM, Liberman UA, Lindsay R, Martin TJ, Masri B, Mautalen CA, Meunier PJ, Khaltaev N (1999) Interim report and recommendations of the World Health Organization Task-Force for Osteoporosis. Osteoporos Int 10: 259–264

    Article  PubMed  CAS  Google Scholar 

  • Georgala S, Katoulis AC, Hasapi V, Koumantaki-Mathioudaki E (1998) Thalidomide treatment for hypertrophic lupus erythematosus. Clin Exp Dermatol 23: 141

    Article  PubMed  CAS  Google Scholar 

  • Giant TT, Mikecz K, Brennan F, Negroiu G, Bartlett R (1998) Suppression of autoimmune responses and inflammatory events by leflunomide in an animal model for rheumatoid arthritis. J Rheumatol 25: 20–26

    Google Scholar 

  • Glied M, Rico MJ (1999) Treatment of autoimmune blistering diseases. Dermatol Clin 17: 431–440

    PubMed  CAS  Google Scholar 

  • Isaacs JD (2001) From bench to bedside: discovering rules for antibody design, and improving serotherapy with monclonal antibodies. Rheumatology (Oxford) 40: 724–738

    Article  CAS  Google Scholar 

  • Jayne D (1999) Non-transplant uses of mycophenolate mofetil. Curr Opin Nephrol Hypertens 8: 563–567

    Article  PubMed  CAS  Google Scholar 

  • Jeffes EW 3rd, McCullough JL, Pittelkow MR, McCormick A, Almanzor J, Liu G, et al (1995) Methotrexate therapy of psoriasis: differential sensitivity of proliferating lymphoid and epithelial cells to the cytotoxic and growth-inhibitory effects of methotrexate. J Invest Dermatol 104: 184–188

    Article  Google Scholar 

  • Jolles S, Hughes J, Whittaker S (1998) Dermatological uses of high-dose intravenous immunoglobulin. Arch Dermatol 134: 80–86

    Article  PubMed  CAS  Google Scholar 

  • Joly P, Roujeau JC, Benichou J, Picard C, Dreno B, Delaporte E, Vaillant L, D’Incan M, Plantin P, Bedane C, Young P, Bernard P, The Bullous Diseases French Study Group (2002) A comparison of oral and topical corticosteroids in patients with bullous pemphigoid. N Engl J Med 346: 321–327

    Article  PubMed  CAS  Google Scholar 

  • Krueger JG (2002) The immunologic basis for the treatment of psoriasis with new biologic agents. J Am Acad Dermatol 46: 1–23

    Article  PubMed  Google Scholar 

  • Kurtz ES, Bay ley SC, Arshad F, Lee AA, Przekop PA (1995) Leflunomide: an active antiinflammatory and antiproliferative agent in models of dermatologic disease. Inflamm Res 44: 187–188

    Article  Google Scholar 

  • Kyriakis KP, Kontochristopoulos GJ, Panteleos DN (2000) Experience with low-dose thalidomide therapy in chronic discoid lupus erythematosus. Int J Dermatol 39: 218–222

    Article  PubMed  CAS  Google Scholar 

  • Lamba S, Lebwohl M (2001) Combination therapy with vitamin D analogues. Br J Dermatol 144: 27–32

    PubMed  CAS  Google Scholar 

  • Luger T (2001) Treatment of immune-mediated skin diseases: future perspectives. Eur J Dermatol 11: 343–347

    PubMed  CAS  Google Scholar 

  • Mrowietz U (2001) Advances in systemic therapy for psoriasis. Clin Dermatol 26: 362–367

    Article  CAS  Google Scholar 

  • Mrowietz U, Christophers E, Altmeyer P (1999) Treamtent of severe psoriasis with fumaric acid esters scientific background and guidelines for therapeutic use. Br J Dermatol 141: 424–429

    Article  PubMed  CAS  Google Scholar 

  • Nousari HG, Anhalt GJ (2000) Bullous pemphigoid treated with leflunomide. Arch Dermatol 136: 1204–1205

    Article  PubMed  CAS  Google Scholar 

  • Ochsendorf FR, Runne U (1996) Chloroquine: consideration of maximum daily dose (3.5 mg/kg ideal body weigth) prevents retinopathy. Dermatology 192: 382–383

    Article  PubMed  CAS  Google Scholar 

  • O’Donnell BF, Barr RM, Black AK, Francis DM, Kermani F, Niimi N, Barlow RJ, Winkelmann RK, Greaves MW (1998) Intravenous immunoglobulin in autoimmune chronic urticaria. Br J Dermatol 138: 101–106

    Article  PubMed  Google Scholar 

  • Ordi-Ros J, Cortes F, Cucrull E, Mauri M, Bujan S, Vilardell M (2000) Thalidomide in the treatment of cutaneous lupus refractory to conventional therapy. J Rheumatol 27: 1429–1433

    PubMed  CAS  Google Scholar 

  • Parnham MJ (1995) Leflunomide: a potential new disease modifying anti-rheumatic drug. Exp Opin Invest Drugs 4: 777–779

    Article  CAS  Google Scholar 

  • Prinz JC, Meurer M, Reiter C, Rieber EP, Plewig G, Riethmuller G (1996) Treatment of severe cutaneous lupus erythematosus with a chimeric CD4 monoclonal antibody, cM-T412. J Am Acad Dermatol 34: 244–252

    Article  PubMed  CAS  Google Scholar 

  • Rabinovitch N, Gelfand EW, Leung DY (1999) The role of immunoglobulin therapy in allergic diseases. Allergy 54: 662–668

    Article  PubMed  CAS  Google Scholar 

  • Richter HI, Krutmann J, Goerz G (1998) Extrakorporale Photopherese bei therapieresistentem disseminiert diskoidem Lupus erythematodes. Hautarzt 49: 487–491

    Article  PubMed  CAS  Google Scholar 

  • Robert C, Kupper TS (1999) Inflammatory skin diseases, T cells and immune surveillance. N Engl J Med 341: 1817–1828

    Article  PubMed  CAS  Google Scholar 

  • Roujeau JC (1999) Treatment of severe drug eruptions. J Dermatol 26: 718–722

    PubMed  CAS  Google Scholar 

  • Rzany B, Partscht K, Jung M, Kippes W, Mecking D, Baima B, Prudlo C, Pawelczyk B, Messmer EM, Schumann M, Sinkgraven R, Biichner L, Budinger L, Pfeiffer C, Sticherling M, Hertl M, Kaiser H-W, Meurer M, Zillikens D, Messer G (2002) Risk factors for lethal outcome in patients with bullous pemphigoid. Arch Dermatol 138: 903–908

    Article  PubMed  Google Scholar 

  • Sacher RA (2001) Intravenous immunoglobulin consensus statement. J Allergy Clin Immunol 108: 139–146

    Article  Google Scholar 

  • Sadayama T, Miyagawa S, Shirai T (1999) Low-dose intravenous immunoglobulin therapy for intractable dermatomyositis skin lesions. J Dermatol 26: 457–459

    Google Scholar 

  • Saeki Y, Oshima S, Kurimoto I, Miura H, Suemura M (2000) Maintaining remission of lupus erythematosus profundus (LEP) with cyclosporin A. Lupus 9: 390–392

    Article  PubMed  CAS  Google Scholar 

  • Sapadin AN, Fleischmajer R (2002) Treatment of scleroderma. Arch Dermatol 138: 99–105

    Article  PubMed  CAS  Google Scholar 

  • Sauder DN (2000) Immunomodulatory and pharmacologic properties of imiquimod. J Am Acad Dermatol 43: S6–S11

    Article  PubMed  CAS  Google Scholar 

  • Sticherling M (2001) Chronic cutaneous lupus erythematosus. In: Hertl M (ed) Autoimmune disease of the skin: pathogenesis, diagnosis, management. Springer, Wien New York, pp 169–187

    Google Scholar 

  • Tan BB, Lear TJ, Gawkrodger DJ, English JS (1997) Azathioprine in dermatology: a survey of current practice in the UK. Br J Dermatol 136: 351–355

    Article  PubMed  CAS  Google Scholar 

  • Thivolet J, Nicolas JF, Kanitakis J, Lyonnet S, Chouvet B (1990) Recombinant interferon alpha 2a is effective in the treatment of discoid and subacute cutaneous lupus erythematosus. Br J Dermatol 122: 405–409

    Article  PubMed  CAS  Google Scholar 

  • Thoma-Uszynski S, Hertl M (2001) Novel therapeutic approaches in autoimmune skin disorders. In: Hertl M (ed) Autoimmune disease of the skin: pathogenesis, diagnosis, management. Springer, Wien New York, pp 337–364

    Google Scholar 

  • Warren KJ, Nopper AJ, Crosby DL (1998) Thalidomide for recalcitrant discoid lesions in a patient with systemic lupus erythematosus. J Am Acad Dermatol 39: 293–295

    Article  PubMed  CAS  Google Scholar 

  • Werth VP (1993) Management and treatment with systemic glucocorticoids. Adv Dermatol 8: 81–101

    PubMed  CAS  Google Scholar 

  • Wollina U, Looks A (1999) Extracorporeal photochemotherapy in cutaneous lupus erythematosus. J Eur Acad Dermatol Venereol 13: 127–130

    Article  PubMed  CAS  Google Scholar 

  • Wozel G (1996) Dapson: Pharmakologie, Wirkmechanismus und klinischer Einsatz. Thieme, Stuttgart.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer-Verlag Wien

About this chapter

Cite this chapter

Sticherling, M. (2003). Therapeutic aspects of autoimmune diseases of the skin. In: Sticherling, M., Christophers, E. (eds) Treatment of Autoimmune Disorders. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6016-9_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-6016-9_12

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7288-9

  • Online ISBN: 978-3-7091-6016-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics