Treatment of bullous pemphigoid with adjuvant immunoadsorption: A case series Michael Kasperkiewicz, MD, Franziska Schulze, MD, Markus Meier, MD, Nina.

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Treatment of bullous pemphigoid with adjuvant immunoadsorption: A case series Michael Kasperkiewicz, MD, Franziska Schulze, MD, Markus Meier, MD, Nina van Beek, MD, Martin Nitschke, MD, Detlef Zillikens, MD, Enno Schmidt, MD, PhD Journal of the American Academy of Dermatology Volume 71, Issue 5, Pages 1018-1020 (November 2014) DOI: 10.1016/j.jaad.2014.06.014 Copyright © 2014 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Patient characteristics and relationship between clinical stages and serum anti-bullous pemphigoid (BP)180 NC16A enzyme-linked immunosorbent assay (ELISA) levels during the course of the disease of 7 patients with BP treated by adjuvant immunoadsorption (IA) in addition to prednisolone (PRE), dapsone (DAP), and topical clobetasol propionate 0.05% ointment (CLO). One patient (4-pointed star) received additional consecutive immunosuppressive treatment with azathioprine/mycophenolate mofetil (MMF) and methotrexate (MTX) because of refractory/new skin lesions, only minor initial reduction of circulating autoantibodies, and concomitant rheumatoid arthritis. In 1 patient (square), who died 3 months after IA, last autoantibody testing was only available 2 months after IA. Another patient (cross) died 10 months after IA. Long interrupted line corresponds to the cut-off of the ELISA (20 U/mL). F, Female; LE, lower extremities; M, male; TR, trunk; UE, upper extremities. Journal of the American Academy of Dermatology 2014 71, 1018-1020DOI: (10.1016/j.jaad.2014.06.014) Copyright © 2014 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Representative clinical pictures of a patient with bullous pemphigoid (multiserrated star in Fig 1) before and 1 month after adjuvant immunoadsorption (IA). Journal of the American Academy of Dermatology 2014 71, 1018-1020DOI: (10.1016/j.jaad.2014.06.014) Copyright © 2014 American Academy of Dermatology, Inc. Terms and Conditions