Seborrheic Pemphigus, Antigen Mimicry and the Subsequent-Wrong Diagnostic and Therapeutic Approach?

Authors

  • Anastasiya Atanasova Chokoeva Medical University Plovdiv - Dermatology and Venereology, Vasil Aprilov 15A, Plovdiv 4000
  • Ilia Lozev Medical Institute of Ministry of Interior Department of General, Vascular and Abdominal Surgery, Sofia
  • Irina Yungareva Medical Institute of Ministry of Interior (MVR-Sofia), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia
  • Uwe Wollina Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen
  • Torello Lotti University G. Marconi of Rome - Dermatology and Venereology, Rome
  • Georgi Konstantinov Maximov ”Onkoderma”- Policlinic for Dermatology and Dermatologic Surgery, Sofia
  • Georgi Tchernev Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior (MVR-Sofia), General Skobelev 79, 1606 Sofia; Onkoderma - Policlinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia

DOI:

https://doi.org/10.3889/oamjms.2018.011

Keywords:

Seborrheic pemphigus, Autoantibodies, DIF, Screening, Hepatitis B

Abstract

It is well-established that drugs could be leading cause of occurrence of numerous diseases, including pemphigus, being either inducer or triggering factor of the autoimmunity. Despite medications, it should be kept in mind that chronic or acute infections are also capable of being a trigger in various types of cutaneous eruptions, including pemphigus. The rapidly obtained and uncompleted history for accompanied medication leads to general mistakes in the subsequent treatment approach, as the first step in such cases is discontinuation of the drug-inductor. The absence of this information guaranties the fail of the treatment. On the other hand, the lack of performed screening for chronic or acute hepatitis and tuberculosis is not the only mistake, regarding the high dosage of immunosuppressors that have been planned as regiment and the possible fatal effect on the infection’s spread or exacerbation, but also because of the possible triggering ability of chronic or acute infection, which may play also a key role in the generation of antigen- or molecular- mimicry, as a potential source of antibodies reactive with various tissue antigens. It turns out that although the diagnosis of pemphigus in regular cases is usually not a challenge, the treatment occasionally could be, just because of a simple pitfall in anamnesis and screening, as in the presented case. Herein, we present a case of a patient with seborrheic pemphigus, which is strongly demonstrative for these statements, as we want to emphasise the importance of the first and the most powerful clinician’s weapons – the patient’s history and thorough examination.

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Published

2018-01-13

How to Cite

1.
Chokoeva AA, Lozev I, Yungareva I, Wollina U, Lotti T, Maximov GK, Tchernev G. Seborrheic Pemphigus, Antigen Mimicry and the Subsequent-Wrong Diagnostic and Therapeutic Approach?. Open Access Maced J Med Sci [Internet]. 2018 Jan. 13 [cited 2021 Apr. 12];6(1):128-31. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.011

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