Intravenous immunoglobulin in the treatment of autoimmune bullous dermatoses: An update

Abstract

High-dose intravenous immunoglobulin (IVIg) is being increasingly utilized as an off-label therapy for a variety of autoimmune and inflammatory conditions across various specialties. Numerous reports have shown that it is an effective treatment for autoimmune skin blistering disorders. Unlike most therapies for blistering disorders, IVIg is not immunosuppressive and has a favorable side effect profile. This has allowed its use to expand dramatically over the last decade. However, due to the rarity and severity of autoimmune skin blistering diseases, well-designed prospective trials are generally lacking. This work highlights major research developments and the best evidence to date regarding the treatment of autoimmune pemphigus, bullous pemphigoid, mucous membrane pemphigoid, epidermolysis bullosa acquisita, pemphigoid gestationis, and linear IgA dermatosis with IVIg, providing an update on its efficacy, proposed mechanisms of action, side effect profile, and indications for use.

Keywords::

• Pemphigus
• pemphigoid
• epidermolysis bullosa acquisita
• apoptolysis
• IVIg
• treatment

Declaration of Interest: This work was supported in part by U.S. Food and Drug Administration Grant No. 1R01FD-03343-01 (to JCB). The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.