M.-L. Sigal

TL;DR: It is found that rituximab therapy can help pemphigus patients even after 6 years, in part by reshaping the B cell repertoire during reconstitution, allowing for long-term effects in addition to the short-term loss of pathogenic B cells.

Abstract: Objective To identify the prognostic factors of bullous pemphigoid (BP). Design Prospective study of patients with BP included in a randomized, controlled trial. Setting Twenty dermatology departments in France. Patients One hundred seventy patients with BP initially treated with a 40-g/d dosage of clobetasol propionate cream (testing sample) and 171 patients initially treated with oral corticosteroids at a dosage of 0.5 or of 1.0 mg/kg per day, depending on the extent of BP (validation samples). Main Outcome Measures The end point was overall survival during the first year after BP diagnosis. From the testing sample, associations of clinical and biological variables with overall survival were assessed using univariate and multivariate analyses. Selected predictors were included in a prognostic model. To verify that these predictors were not dependent on the treatment used, the model was then validated independently on the 2 series of BP patients treated with oral corticosteroids. Results Median age of the BP patients included in the testing sample was 83 years. The 1-year Kaplan-Meier survival rate was 74%. From univariate analysis, the main deleterious predictors were demographic factors (ie, older age and female sex), associated medical conditions (ie, cardiac insufficiency, history of stroke, and dementia), and low Karnofsky score, which is a measure of the patient’s general condition. No factors directly related to BP, in particular extent of cutaneous lesions, were shown to be related to the patients’ prognosis. From multivariate analysis, only older age (P = .02) and low Karnofsky score (P Conclusions The prognosis of patients with BP is influenced by age and Karnofsky score. These predictors are easy to use and should facilitate the management of BP.

TL;DR: The prognosis of patients with BP is influenced by age and Karnofsky score, which is a measure of the patient's general condition, and these predictors are easy to use and should facilitate the management of BP.

TL;DR: Psoriasis is associated with higher prevalences of cardiovascular and metabolic comorbidities in adults but the relationship of age at onset and those prevalences is unknown.

TL;DR: In this article, a serie of neuf cases of pelade survenus au cours de traitements par anti-TNF alpha, representant un effet indesirable cutane tres peu decrit a ce jour.