A patient with recalcitrant oral pemphigus vulgaris successfully treated with a biologic drug- Rituximab
Recalcitrant oral pemphigus treated with rituximab
Pemphigus vulgaris (PV) is a chronic autoimmune blistering disease affecting mucous membranes and the skin. Rituximab (RTX), a monoclonal antibody against CD20, has been approved by FDA for the treatment of adults with moderate to severe PV. A 42-year-old Indian woman, previously diagnosed with oral PV in 2006, presented to our clinic with painful erosions and ulcers of her oral mucosa in 2012. She was treated with available evidence based immunosuppressants with limited success. Because of the refractory disease and her poor quality of life, RTX was given observing the lymphoma protocol. Her pathology improved dramatically after the first month of RTX with continuous resolution and no significant new lesions appearing to date. RTX is an effective treatment for recalcitrant oral PV. Our case is a therapeutic first in South Africa.