Psoriatic erythroderma and bullous pemphigoid treated successfully with acitretin and azathioprine. 1999

C Roeder, and P V Driesch
Department of Dermatology, University of Erlangen Nuremberg, Hartmannstrasse 14, 91052 Erlangen, Germany.

We present the case of a 59-year-old male patient who developed lesions of a bullous pemphigoid during the course of a long-lasting severe psoriasis which had been treated for years with different topical treatments as well as with PUVA and UV-B radiations. Our patient was successfully treated with a combination of acitretin and azathioprine (follow up 28 months). Our case shows that it is possible to avoid systemic corticosteroid treatment in this difficult therapeutic situation.

UI MeSH Term Description Entries
D007166 Immunosuppressive Agents Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging. Immunosuppressant,Immunosuppressive Agent,Immunosuppressants,Agent, Immunosuppressive,Agents, Immunosuppressive
D007641 Keratolytic Agents Agents that soften, separate, and cause desquamation of the cornified epithelium or horny layer of skin. They are used to expose mycelia of infecting fungi or to treat corns, warts, and certain other skin diseases. Desquamating Agents,Skin-Peeling Agents,Agents, Desquamating,Agents, Keratolytic,Agents, Skin-Peeling,Skin Peeling Agents
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010391 Pemphigoid, Bullous A chronic and relatively benign subepidermal blistering disease usually of the elderly and without histopathologic acantholysis. Pemphigoid,Bullous Pemphigoid,Pemphigoids
D011565 Psoriasis A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. Palmoplantaris Pustulosis,Pustular Psoriasis of Palms and Soles,Pustulosis Palmaris et Plantaris,Pustulosis of Palms and Soles,Psoriases
D003873 Dermatitis, Exfoliative The widespread involvement of the skin by a scaly, erythematous dermatitis occurring either as a secondary or reactive process to an underlying cutaneous disorder (e.g., atopic dermatitis, psoriasis, etc.), or as a primary or idiopathic disease. It is often associated with the loss of hair and nails, hyperkeratosis of the palms and soles, and pruritus. (From Dorland, 27th ed) Dermatitis Exfoliative,Dermatitis Exfoliative Generalised,Dermatitis Exfoliative Generalized,Erythroderma,Dermatitis Exfoliativa,Dermatitis Exfoliative Generaliseds,Dermatitis Exfoliatives,Erythrodermas,Exfoliative Dermatitides,Exfoliative Dermatitis,Exfoliative Generalised, Dermatitis,Exfoliative Generalized, Dermatitis,Exfoliative, Dermatitis,Exfoliatives, Dermatitis,Generalised, Dermatitis Exfoliative
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001379 Azathioprine An immunosuppressive agent used in combination with cyclophosphamide and hydroxychloroquine in the treatment of rheumatoid arthritis. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), this substance has been listed as a known carcinogen. (Merck Index, 11th ed) Azathioprine Sodium,Azathioprine Sodium Salt,Azathioprine Sulfate,Azothioprine,Immuran,Imuran,Imurel,Sodium, Azathioprine

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