Tag Archives: azathioprine

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-262">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-261">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-260">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-259">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-258">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-257">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-256">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-255">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-254">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-253">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-252">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-251">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-250">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-249">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-246">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-245">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-243">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-242">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-241">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-239">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-238">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-236">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-235">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-234">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-232">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-231">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-230">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-229">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-226">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-225">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-224">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-223">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-222">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-221">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-220">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-219">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-212">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-211">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-209">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-208">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-207">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-206">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-205">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-201">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-198">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-197">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-196">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-195">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-194">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-193">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-192">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-191">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-190">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-189">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-188">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-187">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-186">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-185">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-184">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-183">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-181">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-180">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-178">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-177">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-176">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-175">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-174">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-173">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-172">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-171">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-169">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-168">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-167">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-165">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-164">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-163">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-162">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-161">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-160">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-159">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-158">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-157">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-156">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-155">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-154">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-153">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-149">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-147">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-146">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-145">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-144">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-143">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-142">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-141">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-139">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-138">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-137">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-136">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-135">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-134">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-133">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-132">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-131">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-130">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-129">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-128">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-127">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-126">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-125">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-124">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-123">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-122">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-121">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-120">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-119">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-118">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-117">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-116">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-115">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-114">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-113">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-112">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-111">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-110">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-108">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-104">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-103">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-88">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-87">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-86">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-85">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-84">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-83">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-82">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-81">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-80">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-79">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-74">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-73">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-72">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-71">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-65">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-64">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-63">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-36">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-25">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-21">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-20">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-17">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-16">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-15">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-12">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-6">div class="row">
The clinical and epidemiological features of pemphigus vulgaris (PV) are well documented but there remain few reports of oesophageal involvement of PV. Although previously considered to be rare, recent reports have suggested that up to 87% of patients with PV may have symptoms, or endoscopic features, of oesophageal disease that may be poorly responsive to conventional corticosteroid-sparing immunosuppression.

The present report details the clinical and immunological features of a 53 year old Asian female who developed symptoms and signs of oesophageal PV during therapy with azathioprine and decreasing prednisolone dosage. Oesophageal involvement occurred during stable oral disease.

Oesophageal involvement can occur without significant oro-cutaneous lesions and immunological evidence of PV. This suggests that immunological targets for oesophageal disease may differ from those of other mucocutaneous areas, and that conventional first-line systemic therapy may not be effective for oesophageal lesions.

Full article available at: http://www.ingentaconnect.com/content/ubpl/wlmj/2012/00000004/00000002/art00001

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-262">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-261">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-260">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-259">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-258">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-257">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-256">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-255">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-254">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-253">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-252">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-251">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-250">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-249">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-246">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-245">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-243">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-242">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-241">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-239">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-238">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-236">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-235">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-234">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-232">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-231">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-230">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-229">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-226">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-225">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-224">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-223">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-222">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-221">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-220">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-219">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-212">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-211">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-209">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-208">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-207">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-206">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-205">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-201">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-198">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-197">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-196">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-195">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-194">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-193">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-192">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-191">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-190">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-189">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-188">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-187">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-186">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-185">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-184">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-183">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-181">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-180">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-178">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-177">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-176">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-175">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-174">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-173">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-172">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-171">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-169">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-168">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-167">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-165">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-164">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-163">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-162">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-161">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-160">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-159">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-158">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-157">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-156">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-155">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-154">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-153">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-149">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-147">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-146">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-145">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-144">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-143">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-142">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-141">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-139">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-138">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-137">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-136">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-135">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-134">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-133">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-132">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-131">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-130">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-129">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-128">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-127">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-126">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-125">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-124">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-123">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-122">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-121">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-120">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-119">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-118">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-117">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-116">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-115">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-114">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-113">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-112">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-111">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-110">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-108">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-104">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-103">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-88">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-87">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-86">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-85">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-84">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-83">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-82">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-81">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-80">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-79">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-74">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-73">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-72">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-71">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-65">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-64">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-63">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-36">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-25">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-21">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-20">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-17">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-16">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-15">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-12">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-6">div class="row">
A 14-year-old male presented with seven years history of recurrent episodes of fluid filled, itchy and eroded lesions over the body not responding to oral corticosteroids and azathioprine. Dermatological examination revealed crusted plaques and erosions in a seborrheic distribution. Histopathology of skin lesions and direct immunofluorescence were characteristic of pemphigus foliaceus. He was treated with dexamethasone pulse therapy with inadequate response. However, relapsing skin lesions revealed a circinate arrangement with a predilection to trunk and flexures. In view of clinical features suggestive of IgA pemphigus, he was started on dapsone, to which he responded dramatically in four weeks. However, repeat biopsy continued to reveal features of pemphigus foliaceus and ELISA for anti- desmoglein 1 antibodies was positive.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-262">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-261">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-260">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-259">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-258">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-257">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-256">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-255">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-254">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-253">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-252">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-251">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-250">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-249">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-246">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-245">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-243">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-242">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-241">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-239">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-238">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-236">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-235">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-234">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-232">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-231">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-230">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-229">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-226">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-225">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-224">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-223">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-222">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-221">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-220">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-219">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-212">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-211">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-209">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-208">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-207">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-206">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-205">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-201">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-198">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-197">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-196">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-195">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-194">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-193">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-192">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-191">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-190">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-189">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-188">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-187">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-186">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-185">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-184">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-183">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-181">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-180">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-178">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-177">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-176">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-175">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-174">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-173">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-172">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-171">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-169">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-168">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-167">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-165">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-164">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-163">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-162">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-161">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-160">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-159">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-158">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-157">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-156">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-155">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-154">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-153">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-149">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-147">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-146">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-145">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-144">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-143">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-142">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-141">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-139">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-138">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-137">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-136">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-135">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-134">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-133">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-132">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-131">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-130">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-129">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-128">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-127">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-126">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-125">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-124">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-123">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-122">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-121">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-120">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-119">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-118">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-117">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-116">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-115">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-114">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-113">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-112">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-111">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-110">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-108">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-104">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-103">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-88">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-87">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-86">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-85">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-84">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-83">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-82">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-81">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-80">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-79">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-74">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-73">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-72">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-71">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-65">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-64">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-63">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-36">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-25">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-21">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-20">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-17">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-16">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-15">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-12">span class="explanatory-dictionary-highlight" data-definition="explanatory-dictionary-definition-6">div class="row">
Background  The classic treatment for pemphigus vulgaris is prednisolone. Immunosuppressive drugs can be used in association.

Objective  To compare the efficacy of Azathioprine in reducing the Disease Activity Index (DAI).

Patients and methods  A double blind randomized controlled study was conducted on 56 new patients, assigned to two therapeutic groups: (i) prednisolone plus placebo; (ii) prednisolone plus Azathioprine. Patients were checked regularly for 1 year. ‘Complete remission’ was defined as healing of all lesions after 12 months, and prednisolone <7.5 mg daily, (DAI ≤ 1). Analysis was done by ‘Intention To Treat’ (ITT) and ‘Treatment Completed Analysis’ (TCA).

Results  Both groups were similar in age, gender, disease duration, and DAI. Primary endpoint: By ITT and TCA, the mean DAI improved in both groups with no significant difference between them. The difference became significant for the last trimester (3 months; ITT:P = 0.033, TCA: P = 0.045). Secondary endpoint: The total steroid dose decreased significantly in both groups, with no significant difference between them, except for the last trimester (ITT: P = 0.011, TCA: P = 0.035). The mean daily steroid dose decreased gradually in both groups becoming statistically significant in favour of azathioprine, in the last trimester, especially at 12th months (ITT: P = 0.002, TCA:P = 0.005). Complete remission was significant at 12 months only for TCA (AZA/Control: 53.6%/39.9%, P = 0.043).

Limitations  Sample size was rather small to demonstrate all differences. Other limitations include the choice of primary and secondary endpoints and the unavailability to measure thiopurine methyltransferase activity.

Conclusion  Azathioprine helps to reduce prednisolone dose in long-run.

Full article available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1468-3083.2012.04717.x/abstract;jsessionid=4F8C646E8902BB54AC0026B542EF91FD.d03t01