A patient with refractory oral pemphigus vulgaris successfully treated with a biologic drug- Rituximab: A case report

Abstract

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 FDAfor the treatment of adults with moderate to severe PV. A42-year-old Indian woman, with refractory oral PV presented to our clinic with painful erosions and ulcers of her oral mucosa. She was treated with available evidence based immunosuppressants with limited success over a period of 8 years. RTX was given observing the lymphoma protocol. Her symptoms improved dramatically after the first month of RTX with sustained resolution on low doses of prednisone, mycophenolate mofetil and no significant new lesions appearing to date. Her quality of life improved significantly. RTX seemed an effective treatment for refractory oral PV.

Keywords: Pemphigus vulgaris, rituximab, autoimmune, mucocutaneous.