Category Archives: Issue 53 – Summer 2008

The Journal of the European Academy of Dermatology and Venereology (JEADV) printed, in its Letters to the Editor section, a case study from the Department of Dermatology, Valencia University General Hospital, in Spain. Pemphigus Vulgaris Associated with Cocaine Snorting. It was reported that a patient was admitted to the hospital with severe erosions on his body and diagnosed with pemphigus vulgaris. The patient was given 90 mg of prednisone and sent home. His disease did not subside so they added 1 gram of CellCept. The patient’s disease did not get better.

After a toxicology report was positive for cocaine, the patient admitted to being addicted to the drug. After management of his addiction began, the patient’s pemphigus rapidly improved. The patient had 2 severe relapses while on 60 mg of prednisone and 1 g daily of CellCept. The PV relapses coincided with his continued use of cocaine.

Because of the sequence of events, the authors concluded that cocaine consumption might have been a factor in the development of disease process. They suggested that physicians should be aware of the possibility of the use of recreational drugs among certain patients, and that because of a lack of coordinated efforts between the disease state and the addiction, these patients are more likely to relapse back into their drug habits and cause the worsening of their disease.

A research team, led by Janet Fairley, M.D., at the University of Iowa, is investigating the role of IgE-type antibodies in bullous pemphigoid. Most of the previous work in pemphigoid has focused on IgG antibodies and while the presence of IgE in pemphigoid has been known for many years, Fairley and her group have recently shown that the IgE antibodies contribute to lesion formation in pemphigoid.

Dr. Janet FairleyBased on these finding, the group has initiated a trial studying the safety and effectiveness of omalizumab (Xolair), an anti-IgE medication, in bullous pemphigoid. Omalizumab is currently approved for the treatment of asthma and the hope is that in pemphigoid it will minimize or eliminate the need for steroids

This trial is truly translational research that aims to bring findings from the laboratory into the clinical setting in order to improve patient care. The pilot trial will compare the use of omalizumab to standard prednisone treatment in 12 patients and will last for 24 weeks. Carrying out the trial at the University of Iowa will be greatly facilitated by the fact that Iowa is one of 24 institutions in the nation recently awarded a $33.8M Clinical and Translational Science Award (CTSA). These awards are designed to help researchers bring new diagnostic methods and treatments to patients by assisting in the design, execution and data analysis of research studies. Genentech will be providing the medication for patients in the trial.

Patients are still being recruited for the study and may contact Deb Brandt at 319-353-6439 or The IPPF encourages you to support this important clinical trial work.

When it comes to action, this group definitely puts the pedal to the metal… I am so grateful to all of you that offered me input about Dr. Grant Anhalt, getting around the Baltimore area, lodging suggestions, and most of all encouragement. When I was flying the friendly skies, all of you were with me. I could feel your love, support and cheering me on as I approached the city of Baltimore. It’s difficult enough finding a local doctor, giving him your trust and praying that his treatment will be successful. Traveling 1500 miles away is a totally different story. Hopefully,

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this story will have a happy ending. I was very impressed with Dr. Anhalt, his staff and the Johns Hopkin’s facility in Baltimore, Maryland. His knowledge, enthusiasm, and willingness to move on to Plan B made the trip all that I had hoped it would be. I am now on Cellcept and awaiting my first infusion of Rituxan on June 6th in my home town of Lake Charles, Louisiana. Dr. Anhalt is always willing to share his expertise with other physicians and responds to email in a timely manner. My local rheumatologist will be consulting with Dr. Anhalt, so I feel confident in the new treatment plan. I want to once again thank all of you for being in my corner. Our group definitely pays it forward. From welcoming new members, to answering the craziest of questions, to responding to someone in need, you are the very best.

The PEM Friends 2008 away weekend here in sunny Ashton-under-Lyne, Gtr. Manchester, will take place over three days and two nights, June 27th-29th, 2008. Happily, Janet Segall, founder of the International Pemphigus & Pemphigoid Foundation in America, is expecting to come over from California to join us.

Dave from America is also going to be with us this year. On Saturday evening, there will be a gala dinner in our house – fancy gowns ladies and smart casual for the men. There will be a whole dressed salmon delivered, vegetarians will be catered for, wine and non-alcholic drinks provided. For more information contact Carolyn at


Our shining star, Carolyn Blain came to Providence, Rhode Island for Thanksgiving this past year to take part in a family event. This happy circumstance became the occasion to get together with some of our community in Rhode Island and Massachusetts to sit down for a lively lunch. So on November 24, 2007, the Saturday following the big feast day, a few of us gathered at the ZBar on Wickenden Street in Providence for yet more wonderful food, and we had the place almost all to ourselves. We took full advantage of that to make ourselves right at home. Carolyn brought many requested items from England, and even a marvelous gift or two.

Once again, I am reminded that the International Pemphigus & Pemphigoid Foundation has had many terrific outcomes. One in particular is the almost immediate links of friendship.

Around our table were, Linda and Merv McKee, Gloria and Alan Papert, Carolyn Blain, Dieter and Yvette Nachmias-Baeu, and Ellen Levine.


Nearly all members of the IPPF Medical Advisory Board attended the autoimmune blistering disease meeting in Japan and many gave presentations on new research in pemphigus and pemphigoid. Clinical speakers from the MAB included Dr. Jean-Claude Bystryn, who spoke about rituximab experience in the USA, and Dr. Pascal Joly who spoke on his rituximab experiences in France. General discussion centered around the design of a new clinical trial of rituximab for pemphigus to be conducted in Europe that will be coordinated by Dr. Joly using different dosing schedules.

The other main discussion was about the development of accurate and clinically useful scoring systems for pemphigus and other AIBDs. Dr Michael Hertl, Germany, spoke on a scoring system proposed by the German group, termed the autoimmune bullous disease intensity score (ABSIS), one of the two present scoring systems. Dr. Victoria Werth, USA, presented on the comparison study performed with patients last August at the University of Pennsylvania, in terms of reliability and validity of two outcome instruments for pemphigus, as well as the international Pemphigus Disease Activity Index (PDAI) and the ABSIS.

Dr. Deede Murell (left) and Dr. Victoria Werth.Presentations on the first day covered the pathogenesis of pemphigus and included IPPF MAB members Dr. Luis Diaz and Dr. Sergei Grando. The chairmen of the meeting included Dr. John Stanley and Dr. Masa Amagai. Other world leaders on the causes of pemphigus presented their new work, including scientists Kathy Green (Chicago), Peter Koch (Denver), Andrew Kowalcyk (Atlanta), and Eliane Mueller (Switzerland), along with dermatologists David Rubenstein (Chapel Hill), Carlo Pincelli (Italy), Aimee Payne (Philadelphia), Yumi Aoyoma (Japan), John Zone (Salt Lake City) and Detlef Zillikens (Germany). Topics included signalling pathways, apoptosis, new animal models of blistering diseases and the role of the immune system.

The International Pemphigus Definitions group held a meeting organized by Dr. Dedee Murrell (Australia), with the help of Dr. Takashi Hashimoto (Japan), at which Dr. Werth presented the international photovalidation study that is underway to compare the two different scoring systems using photographs, so that more experts can participate.

Additional participants in these meetings included MAB members Dr. Russell Hall (Durham, NC), and Dr. Neil Korman (Cincinatti) and blistering disease experts Drs. Kim Yancey (Dallas), Robin Eady (London), Leena Bruckner-Tuderman (Germany), David Woodley (USC) and Giovanna Zambruno (Italy).


Leadership starts at the top and nowhere is that more evident than with the President of the IPPF’s Board of Directors. Dr. Dave Sirois has been instrumental in leading the Foundation to new levels of success. That being said, having the right people in the right places allows the IPPF to continue forward on our journey to new heights.

Joining the IPPF Board of Directors are Dr. Badri Rengarajan from California and Mrs. Rebecca Albrecht-Oling from New York.


alt Badri Rengarajan is a member of the Lehman Brothers biotechnology equity research team supporting financial markets evaluation of development- and commercial-stage biotechnology companies.

Badri has over eight years of interdisciplinary experience in business strategy, product development, regulatory/clinical analysis, and investment evaluation. He is responsible for assessing clinical studies and pipeline compounds.

Previously, he was the regulatory lead for several projects in Genentech’s portfolio, including Rituxan (lupus and indolent non-Hodgkins lymphoma), Tarceva (lung and pancreatic cancer), and anti-NGF (pain), for which Badri crafted regulatory strategy, successfully executed several regulatory filings, and negotiated with the FDA. As a member of Genentech’s regulatory intelligence group, Badri synthesized product approval histories for over 100 oncology, cardiovascular, autoimmune, and specialty therapeutics. Badri began his career in management consulting with McKinsey and Company where he served clients in biotechnology, pharmaceuticals, and devices.

Badri earned his bachelor’s degree in Biology and Public Policy from Harvard University and his M.D. from Yale University, where he received a nomination for best thesis project.


altRebecca Albrecht-Oling coordinates the Library Instruction Program at Purchase College, State University of New York, which focuses on training students, faculty, and staff how to frame information needs, create effective research strategies, and use the library’s resources to execute those strategies. Rebecca is also the liaison for Assistive Technology needs in the Library (coordinating this with Counseling services and computing services on campus). Her collection development responsibilities include literature and Jewish studies. A graduate of Kent State University (M.L.S.), Kansas State University, (M.A.) and Purdue University, B.A., she writes extensively on literacy and electronic resources.

Rebecca admits she has the Gift of Gab and has been a huge resource in attracting gifts and grants to the IPPF as well as to campus library collections. Rebecca and her husband Scott were a bright addition to our Annual Meeting in Dallas, despite missing their two children.

We would like to invite you to be part of our new pemphigus/pemphigoid Health Management Program. This program was specifically designed at Centric Health Resources with the help of the IPPF Medical Advisory Board members and staff. With this information, we will be creating a registry of information about the impact of pemphigus/pemphigoid on patients. This will open the door to improved treatments for current patients and provide information to further the chances of finding treatments with less negative impacts — for generations to come.

Many of you already know me as Director of Patient Services for the IPPF and a pemphigus patient myself. I will be your Peer Health Coach and I will be the person you will be talking with to complete the data collection. After you complete the Enrollment and Consent Form and return it to the IPPF, I will call you to set up an appointment to complete our initial survey. During our call, which will take approximately 30-45 minutes, I will ask you specific questions about your disease process: what drugs you are on, if any; what side effects you might be having; additional health problems that might have occurred due to treatment, etc. Depending on where you are with your disease process that will determine any follow-up contacts. We expect that through this relationship and with the additional support materials for you, your caregiver and your doctor, you, personally, will achieve better health and improved quality of life.

This is a voluntary program, but we need your participation to be successful. Your participation is critical to achieving these goals. Whether you have active disease or not, we need you to help us gather information to help future patients with diagnosis, treatment and cure. The Enrollment and Consent Form and a brochure outlining information about the program are on our website at or we can mail them to you. If you decide to enroll, additional documents will be sent to you. This Health Management Program will help to increase knowledge about pemphigus and pemphigoid, which will ultimately lead to more funding toward research to find a cure.


Are you looking for a way to contribute first-hand to a larger goal that may help you and other people living with pemphigus/pemphigoid (P/P) Many medical professionals agree that since P/P is rare, gathering accurate and complete information on the disease is especially important. The Health Management Program registry has been established in order to better understand the progression of P/P, as well as the different ways in which P/P affects people.

Many of you already know that my garden is a fundamental aspect of my life. I find each dimension of the garden — the change of seasons, the plants that open in the morning and close at night, the patch of sunlight created when I lost a branch in the storm — to bring its own opportunity for grace. I noticed it this morning in particular, as this bouquet of lovely peach roses dropped its petals after a couple days in our 100 heat. The petals that lay on the counter top however, were the most intense yellowy-pink with deep magenta edges. It was magnificent, the dried, dying petals. Part of the grace that is delivered to me from the garden is a (sometimes forced) appreciation for what is unfolding.

So, I’m excited to highlight here, for you, some of the changes that we’ve been putting in place at the IPPF and some of the dreams we hope to make into realities over the next year. I hope you’ll find them to be of benefit to you personally; that you’ll see how they help the IPPF serve more and better; and that you will consider sharing with me your expertise, provided from your perspective as a participant in this organization, so that we may serve in the most meaningful way possible.

I know none of you would miss it, but please consider this a jumpstart encouraging you to read Janet’s letter on page 3. There she describes our Health Management Program, the most critical project we are engaged in for 2008. Please offer 30 to 45 minutes of your time to help us document a disease registry that will be the foundation for improved diagnosis, improved treatment protocols, and more extensive research. It’s a small legacy of time that you can leave which will make a huge difference for generations to come.

Also, if you do business on the Internet, take a look at the more than 30 hours Will has spent organizing and simplifying our web site at ( All the informational content remains, however the layout is expected to be more clear and intuitive. In addition, I hope you come to enjoy the brighter colors and our new logo, designed to prepare us to catch the attention of grantmakers and corporate partners and pharmaceutical contributors.

Finally, we have already started preparations for the 2009 Annual Meeting which will be in Los Angeles April 25, 2009, it’s a great chance to learn, share, console, and laugh.

Please continue to join us as we move forward to use the registry as a resource to pursue NIH funding, to train current practitioners in earlier diagnosis and more effective treatments, to support the next generation of dermatologists to gain experience, and to fund and support scientific advances in the effective treatment protocols. And continue to let us know what changes you’d like to see!

Warm regards,