Cyclophosphamide in the Treatment of Pemphigus Vulgaris and Bullous Pemphigoid

Lawrence S. Krain; Joseph W. Landau; Victor D. Newcomer

doi:10.1001/archderm.1972.01620140005001

Krain, Lawrence S.;Landau, Joseph W.;Newcomer, Victor D.

1972-11-01 00:00:00

Abstract Cyclophosphamide has been used in the management of five patients with pemphigus vulgaris and two patients with bullous pemphigoid. All had developed serious side-effects from corticosteroid therapy, such as gastrointestinal bleeding, severe osteoporosis, diabetes mellitus, and depression. The use of cyclophosphamide made possible, in all patients, the reduction of the high maintenance level of corticosteroid therapy. The only side-effects encountered from therapy with cyclophosphamide were reversible alopecia and leukopenia. This preliminary study indicates that cyclophosphamide is an effective agent in the management of pemphigus vulgaris and bullous pemphigoid. References 1. Lever WF: Pemphigus and Pemphigoid . Springfield, Ill, Charles C Thomas Publisher, 1965. 2. Newcomer VD, Landau JW: Recent advances in the diagnosis and treatment of pemphigus . Calif Med 114:1-11, 1971. 3. Lever WF, Goldberg HS: Treatment of pemphigus vulgaris with methotrexate . Arch Derm 100:70-78, 1969.Crossref 4. Peck SM, Osserman KE, Samuels AJ, et al: Studies in bullous diseases . Arch Derm 103:141-148, 1971.Crossref 5. Wolff K, Schreiner B: Immunosuppressive Therapie bie Pemphigus Vulgaris: Vorlaüfige mit Azathioprin (ImurelR) . Arch Klin Exp Derm 235:63-69, 1969.Crossref 6. Burton JL, Greaves MW, Marks J, et al: Azathioprine in pemphigus vulgaris . Brit Med J 3:84-94, 1970.Crossref 7. Jablonska S, Chorzelski T, Blaszycyk M: Immunosuppressants in the treatment of pemphigus . Brit J Derm 83:315-323, 1970.Crossref 8. Ryan JG: Pemphigus: A 20-year survey of experience with 70 cases . Arch Derm 104:14-21, 1971.Crossref 9. Ebringer A, Mackay IR: Pemphigus vulgaris successfully treated with cyclophosphamide . Ann Intern Med 71:125-127, 1969.Crossref 10. McKelvey EM, Hasegawa J: Cyclophosphamide and pemphigus vulgaris . Arch Derm 103:198-200, 1971.Crossref 11. Lever WF, Hashimoto K: The etiology and treatment of pemphigus and pemphigoid . J Invest Derm 53:373-389, 1969.Crossref 12. Greaves M, Marks J, Burton JL: Azathioprine in treatment of bullous pemphigoid . Brit Med J 1:144-145, 1971.Crossref 13. Beutner EH, Chorzelski T, Jordon R: Autosensitization in Pemphigus and Bullous Pemphigoid . Springfield, Ill, Charles C Thomas Publisher, 1970. 14. Sams WM Jr: Bullous pemphigoid: Is it an immunologic disease? Arch Derm 102:485-497, 1970.Crossref 15. Hersh EM, Wong VE, Henderson ES, et al: Hepatotoxic effects of methotrexate . Cancer 19:600-606, 1966.Crossref 16. Weinstein GD, Cox JW, Suringa D, et al: Evaluation of possible chronic hepatotoxicity from methotrexate for psoriasis . Arch Derm 102: 613-618, 1970.Crossref 17. Paterson PY, Hanson MA, Gerner EW: Cyclophosphamide inhibition of experimental allergic encephalomyelitis in Wistar rats . Proc Soc Exp Biol Med 124:928-932, 1967.Crossref 18. Steinberg AD, Tatal N: Suppression of antibodies to nucleic acids with polyinosinicpolycytidylic acid and cyclophosphamide in murine lupus . Clin Exp Immun 7:687-691, 1970. 19. Vancil E: Workshop on Immunosuppressive Properties of Cyclophosphamide . Evansville, Ind, Mead Johnson & Co, 1971. 20. Livingston R, Carter S: Single Agents in Cancer Chemotherapy . New York, Plenum Publishing Co, 1970. 21. Bruce WB, Mecker B, Valeriote F: Comparison of the sensitivity of normal hematopoietic and transplanted lymphoma colony-forming cells to chemotherapeutic agents administered in vivo . J Nat Cancer Inst 37:233-249, 1966. 22. Laros RK, Penner JA: Refractory thrombocytopenic purpura treated successfully with cyclophosphamide . JAMA 215:445-449, 1971.Crossref 23. A controlled trial of cyclophosphamide in rheumatoid arthritis, Cooperating Clinics Committee of the American Rheumatism Association . New Eng J Med 283:883-889, 1970.Crossref 24. Starzl TE, Halgrimson CG, Penn I, et al: Cyclophosphamide and human organ transplantation . Lancet 2:70-73, 1971.Crossref 25. Auerbach R: Mycosis fungoides successfully treated with cyclophosphamide (Cytoxan) . Arch Derm 101:611-616, 1970.Crossref 26. Higgins LC, Thompson, JG: Psoriasis with arthritis: Chemotherapy with cyclophosphamide, nitrogen mustard and 6-mercaptopurine . Southern Med J 59:1191-1193, 1966.Crossref 27. Siang C, Seah C, Wong KH, et al: Cyclophosphamide in the treatment of systemic lupus erythematosus . Brit Med J 1:333-335, 1966.Crossref 28. Jordon RE, Sams WM Jr, Diaz G, et al: Negative complement immunofluorescence in pemphigus . J Invest Derm 57:407-410, 1971.Crossref 29. Johnson W, Meadows DC: Urinary bladder fibrosis and telangiectasia associated with long-term cyclophosphamide therapy . New Eng J Med 284:290-294, 1971.Crossref 30. Davis E, Boesen B: Cytotoxic Drugs in the Treatment of Cancer . London, Edward Arnold Publishers Ltd, 1969. 31. Worth PHL: Cyclophosphamide and the bladder . Brit Med J 3:182-183, 1971.Crossref 32. Schneck SA, Penn I: De-novo brain tumors in renal-transplant recipients . Lancet 1: 983-986, 1971.Crossref 33. Walder BK, Robertson MR, Jeremy D: Skin cancer and immunosuppression . Lancet 2: 1282-1283, 1971.Crossref 34. Harris CC: Malignancy during methotrexate and steroid therapy for psoriasis . Arch Derm 103:501-504, 1971.Crossref 35. Craig SR, Rosenberg EW: Methotrexate-induced carcinoma? Arch Derm 103:505-506, 1971.Crossref

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Cyclophosphamide in the Treatment of Pemphigus Vulgaris and Bullous Pemphigoid

$Abstract Cyclophosphamide has been used in the management of five patients with pemphigus vulgaris and two patients with bullous pemphigoid. All had developed serious side-effects from corticosteroid therapy, such as gastrointestinal bleeding, severe osteoporosis, diabetes mellitus, and depression. The use of cyclophosphamide made possible, in all patients, the reduction of the high maintenance level of corticosteroid therapy. The only side-effects encountered from therapy with cyclophosphamide were reversible alopecia and leukopenia. This preliminary study indicates that cyclophosphamide is an effective agent in the management of pemphigus vulgaris and bullous pemphigoid. References 1. Lever WF: Pemphigus and Pemphigoid . Springfield, Ill, Charles C Thomas Publisher, 1965. 2. Newcomer VD, Landau JW: Recent advances in the diagnosis and treatment of pemphigus . Calif Med 114:1-11, 1971. 3. Lever WF, Goldberg HS: Treatment of pemphigus vulgaris with methotrexate . Arch Derm 100:70-78, 1969.Crossref 4. Peck SM, Osserman KE, Samuels AJ, et al: Studies in bullous diseases . Arch Derm 103:141-148, 1971.Crossref 5. Wolff K, Schreiner B: Immunosuppressive Therapie bie Pemphigus Vulgaris: Vorlaüfige mit Azathioprin (ImurelR) . Arch Klin Exp Derm 235:63-69, 1969.Crossref 6. Burton JL, Greaves MW, Marks J, et al: Azathioprine in pemphigus vulgaris . Brit Med J 3:84-94, 1970.Crossref 7. Jablonska S, Chorzelski T, Blaszycyk M: Immunosuppressants in the treatment of pemphigus . Brit J Derm 83:315-323, 1970.Crossref 8. Ryan JG: Pemphigus: A 20-year survey of experience with 70 cases . Arch Derm 104:14-21, 1971.Crossref 9. Ebringer A, Mackay IR: Pemphigus vulgaris successfully treated with cyclophosphamide . Ann Intern Med 71:125-127, 1969.Crossref 10. McKelvey EM, Hasegawa J: Cyclophosphamide and pemphigus vulgaris . Arch Derm 103:198-200, 1971.Crossref 11. Lever WF, Hashimoto K: The etiology and treatment of pemphigus and pemphigoid . J Invest Derm 53:373-389, 1969.Crossref 12. Greaves M, Marks J, Burton JL: Azathioprine in treatment of bullous pemphigoid . Brit Med J 1:144-145, 1971.Crossref 13. Beutner EH, Chorzelski T, Jordon R: Autosensitization in Pemphigus and Bullous Pemphigoid . Springfield, Ill, Charles C Thomas Publisher, 1970. 14. Sams WM Jr: Bullous pemphigoid: Is it an immunologic disease? Arch Derm 102:485-497, 1970.Crossref 15. Hersh EM, Wong VE, Henderson ES, et al: Hepatotoxic effects of methotrexate . Cancer 19:600-606, 1966.Crossref 16. Weinstein GD, Cox JW, Suringa D, et al: Evaluation of possible chronic hepatotoxicity from methotrexate for psoriasis . Arch Derm 102: 613-618, 1970.Crossref 17. Paterson PY, Hanson MA, Gerner EW: Cyclophosphamide inhibition of experimental allergic encephalomyelitis in Wistar rats . Proc Soc Exp Biol Med 124:928-932, 1967.Crossref 18. Steinberg AD, Tatal N: Suppression of antibodies to nucleic acids with polyinosinicpolycytidylic acid and cyclophosphamide in murine lupus . Clin Exp Immun 7:687-691, 1970. 19. Vancil E: Workshop on Immunosuppressive Properties of Cyclophosphamide . Evansville, Ind, Mead Johnson & Co, 1971. 20. Livingston R, Carter S: Single Agents in Cancer Chemotherapy . New York, Plenum Publishing Co, 1970. 21. Bruce WB, Mecker B, Valeriote F: Comparison of the sensitivity of normal hematopoietic and transplanted lymphoma colony-forming cells to chemotherapeutic agents administered in vivo . J Nat Cancer Inst 37:233-249, 1966. 22. Laros RK, Penner JA: Refractory thrombocytopenic purpura treated successfully with cyclophosphamide . JAMA 215:445-449, 1971.Crossref 23. A controlled trial of cyclophosphamide in rheumatoid arthritis, Cooperating Clinics Committee of the American Rheumatism Association . New Eng J Med 283:883-889, 1970.Crossref 24. Starzl TE, Halgrimson CG, Penn I, et al: Cyclophosphamide and human organ transplantation . Lancet 2:70-73, 1971.Crossref 25. Auerbach R: Mycosis fungoides successfully treated with cyclophosphamide (Cytoxan) . Arch Derm 101:611-616, 1970.Crossref 26. Higgins LC, Thompson, JG: Psoriasis with arthritis: Chemotherapy with cyclophosphamide, nitrogen mustard and 6-mercaptopurine . Southern Med J 59:1191-1193, 1966.Crossref 27. Siang C, Seah C, Wong KH, et al: Cyclophosphamide in the treatment of systemic lupus erythematosus . Brit Med J 1:333-335, 1966.Crossref 28. Jordon RE, Sams WM Jr, Diaz G, et al: Negative complement immunofluorescence in pemphigus . J Invest Derm 57:407-410, 1971.Crossref 29. Johnson W, Meadows DC: Urinary bladder fibrosis and telangiectasia associated with long-term cyclophosphamide therapy . New Eng J Med 284:290-294, 1971.Crossref 30. Davis E, Boesen B: Cytotoxic Drugs in the Treatment of Cancer . London, Edward Arnold Publishers Ltd, 1969. 31. Worth PHL: Cyclophosphamide and the bladder . Brit Med J 3:182-183, 1971.Crossref 32. Schneck SA, Penn I: De-novo brain tumors in renal-transplant recipients . Lancet 1: 983-986, 1971.Crossref 33. Walder BK, Robertson MR, Jeremy D: Skin cancer and immunosuppression . Lancet 2: 1282-1283, 1971.Crossref 34. Harris CC: Malignancy during methotrexate and steroid therapy for psoriasis . Arch Derm 103:501-504, 1971.Crossref 35. Craig SR, Rosenberg EW: Methotrexate-induced carcinoma? Arch Derm 103:505-506, 1971.Crossref$

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Cyclophosphamide in the Treatment of Pemphigus Vulgaris and Bullous Pemphigoid

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Cyclophosphamide in the Treatment of Pemphigus Vulgaris and Bullous Pemphigoid

Cyclophosphamide in the Treatment of Pemphigus Vulgaris and Bullous Pemphigoid

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