Persistent Nasal Skin Lesions in Pemphigus Patients and the Role of Methotrexate in Treatment: A Case Series Study

Introduction: Nasal involvement might infrequently happen and some lesions may not respond to conventional treatments. Objectives: The current case series report aims to describe the characteristics of 10 confirmed pemphigus vulgaris (PV) and pemphigus foliaceus (PF) patients with nasal skin lesi...

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Main Authors: Mohamad Reza Kavyani, Maryam Daneshpazhooh, Sama Heidari, Navid Namakizadeh Esfahani, Sarina Ahmadian, Arghavan Azizpour, Kamran Balighi
Format: Article
Language:English
Published: Mattioli1885 2025-01-01
Series:Dermatology Practical & Conceptual
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Online Access:https://dpcj.org/index.php/dpc/article/view/4521
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author Mohamad Reza Kavyani
Maryam Daneshpazhooh
Sama Heidari
Navid Namakizadeh Esfahani
Sarina Ahmadian
Arghavan Azizpour
Kamran Balighi
author_facet Mohamad Reza Kavyani
Maryam Daneshpazhooh
Sama Heidari
Navid Namakizadeh Esfahani
Sarina Ahmadian
Arghavan Azizpour
Kamran Balighi
author_sort Mohamad Reza Kavyani
collection DOAJ
description Introduction: Nasal involvement might infrequently happen and some lesions may not respond to conventional treatments. Objectives: The current case series report aims to describe the characteristics of 10 confirmed pemphigus vulgaris (PV) and pemphigus foliaceus (PF) patients with nasal skin lesions who did not respond to conventional treatment options or relapsed after a while and to evaluate the role of methotrexate in treatment. Methods: Data regarding patient demographics, disease type and severity, nasal lesion characteristics, and treatment response was obtained from medical records and direct communication with patients between 2019 and 2023. Results: Eight patients received intravenous rituximab (RTX) and 3 methotrexate. Out of the 8 pemphigus vulgaris (PV) patients who underwent RTX treatment, a total of 18 treatment sessions were carried out. Following RTX therapy, significant improvements in the nasal lesions were observed after 11 (61.1%) sessions, with 8 patients (44.4%) achieving complete resolution within 6 months. Additionally, 3 patients who did not have satisfactory results after RTX treatment, received methotrexate, and all of them experienced complete recovery of their nasal lesions within the same time frame. Conclusions: All the patients who benefited from methotrexate never experienced complete remission of their nasal lesions before. It seems methotrexate can be an eligible choice for recalcitrant cases.
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spelling doaj-art-df193816ffce46768455bc5d962b8f1e2025-02-04T15:41:42ZengMattioli1885Dermatology Practical & Conceptual2160-93812025-01-0115110.5826/dpc.1501a4521Persistent Nasal Skin Lesions in Pemphigus Patients and the Role of Methotrexate in Treatment: A Case Series StudyMohamad Reza Kavyani 0Maryam Daneshpazhooh1Sama Heidari2Navid Namakizadeh Esfahani3Sarina Ahmadian 4Arghavan Azizpour5Kamran Balighi6Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2.Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, IranDepartment of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2.Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, IranDepartment of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2.Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, IranDepartment of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2.Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, IranSchool of Medicine, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2.Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, IranDepartment of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2.Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran Introduction: Nasal involvement might infrequently happen and some lesions may not respond to conventional treatments. Objectives: The current case series report aims to describe the characteristics of 10 confirmed pemphigus vulgaris (PV) and pemphigus foliaceus (PF) patients with nasal skin lesions who did not respond to conventional treatment options or relapsed after a while and to evaluate the role of methotrexate in treatment. Methods: Data regarding patient demographics, disease type and severity, nasal lesion characteristics, and treatment response was obtained from medical records and direct communication with patients between 2019 and 2023. Results: Eight patients received intravenous rituximab (RTX) and 3 methotrexate. Out of the 8 pemphigus vulgaris (PV) patients who underwent RTX treatment, a total of 18 treatment sessions were carried out. Following RTX therapy, significant improvements in the nasal lesions were observed after 11 (61.1%) sessions, with 8 patients (44.4%) achieving complete resolution within 6 months. Additionally, 3 patients who did not have satisfactory results after RTX treatment, received methotrexate, and all of them experienced complete recovery of their nasal lesions within the same time frame. Conclusions: All the patients who benefited from methotrexate never experienced complete remission of their nasal lesions before. It seems methotrexate can be an eligible choice for recalcitrant cases. https://dpcj.org/index.php/dpc/article/view/4521case series MethotrexateNasal SkinPemphigusPersistentRituximab
spellingShingle Mohamad Reza Kavyani
Maryam Daneshpazhooh
Sama Heidari
Navid Namakizadeh Esfahani
Sarina Ahmadian
Arghavan Azizpour
Kamran Balighi
Persistent Nasal Skin Lesions in Pemphigus Patients and the Role of Methotrexate in Treatment: A Case Series Study
Dermatology Practical & Conceptual
case series
Methotrexate
Nasal Skin
Pemphigus
Persistent
Rituximab
title Persistent Nasal Skin Lesions in Pemphigus Patients and the Role of Methotrexate in Treatment: A Case Series Study
title_full Persistent Nasal Skin Lesions in Pemphigus Patients and the Role of Methotrexate in Treatment: A Case Series Study
title_fullStr Persistent Nasal Skin Lesions in Pemphigus Patients and the Role of Methotrexate in Treatment: A Case Series Study
title_full_unstemmed Persistent Nasal Skin Lesions in Pemphigus Patients and the Role of Methotrexate in Treatment: A Case Series Study
title_short Persistent Nasal Skin Lesions in Pemphigus Patients and the Role of Methotrexate in Treatment: A Case Series Study
title_sort persistent nasal skin lesions in pemphigus patients and the role of methotrexate in treatment a case series study
topic case series
Methotrexate
Nasal Skin
Pemphigus
Persistent
Rituximab
url https://dpcj.org/index.php/dpc/article/view/4521
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