RESUMO
Originally used to treat psoriasis nearly three decades ago, mycophenolic acid, reformulated as mycophenolate mofetil (MMF), has been rediscovered by the world of dermatology. As a relatively well-tolerated immunosuppressive used in organ transplant recipients, MMF has recently been reported to show promise for several dermatologic conditions, including psoriasis, pemphigus vulgaris, pyoderma gangrenosum, bullous lichen planus, and even connective tissue diseases such as lupus erythematosus and dermatomyositis. Although not intended to be exhaustive, this review discusses MMF with regard to its basic pharmacology, its side effects, and its reported efficacy in a variety of dermatologic indications. Relevant literature was retrieved by a Medline search combining the terms "mycophenolate" or "mycophenolic acid" and "skin" or "skin disease" or a number of specific conditions ("psoriasis", "dermatitis", "eczema", "pemphigoid", "pemphigus", "vasculitis", "pyoderma gangrenosum", "Crohn's disease", "graft-versus-host disease", "lichen planus"). As MMF has only been recently re-introduced for dermatologic application, the nature of much of the literature is admittedly that of case reports or case series. Nevertheless, the results are sufficiently promising to warrant further larger, control studies.
Assuntos
Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapêutico , Dermatopatias/diagnóstico , Dermatopatias/tratamento farmacológico , Relação Dose-Resposta a Droga , Esquema de Medicação , Eczema/tratamento farmacológico , Feminino , Doença Enxerto-Hospedeiro , Humanos , Líquen Plano/tratamento farmacológico , Masculino , Ácido Micofenólico/efeitos adversos , Ácido Micofenólico/farmacologia , Gravidez , Psoríase/tratamento farmacológico , Pioderma Gangrenoso/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Dermatopatias Vesiculobolhosas/tratamento farmacológico , Resultado do TratamentoAssuntos
Anti-Infecciosos Locais/uso terapêutico , Antifúngicos/uso terapêutico , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Doenças do Pé/diagnóstico , Doenças do Pé/tratamento farmacológico , Doenças da Unha/diagnóstico , Doenças da Unha/tratamento farmacológico , Contraindicações , Dermatomicoses/fisiopatologia , Diagnóstico Diferencial , Feminino , Doenças do Pé/fisiopatologia , Humanos , Masculino , Doenças da Unha/fisiopatologia , Falha de TratamentoRESUMO
Cicatricial pemphigoid is a chronic vesiculobullous disease of the mucosal epithelium that primarily involves the oral cavity and the eyes. The clinical and histologic features are identical to those of bullous pemphigoid, and these features often can be nonspecific for other disease processes. It is not unusual for a period of 1 year or more to elapse before a diagnosis is made. The diagnosis of cicatricial pemphigoid requires characteristic lesions and histopathologic evidence of immunoglobulin deposition along the basement membrane, as well as a high index of suspicion. The authors detail a case of cicatricial pemphigoid resulting in airway obstruction and present the treatment required for both stabilization of the airway and resolution of the disease process.