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December 1985

Plasmapheresis Therapy for Bullous Pemphigoid

Arch Dermatol. 1985;121(12):1484-1485. doi:10.1001/archderm.1985.01660120010006

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To the Editor.—  The use of plasmapheresis to treat bullous pemphigoid (BP) has been reported in the European literature,1-6 but, to our knowledge, there has been no mention of this in the American literature to date. We herein describe a patient with BP treated with plasmapheresis and also give a review of the literature.

Report of a Case.—  A 68-year-old woman with a diagnosis of BP initially responded to prednisone. Her course was complicated by insulin-requiring diabetes mellitus, severe fluid retention with hypertension, and a myopathy. Her ten hospital admissions for flares of BP are summarized in the Table. Her course was notable for nonhemorrhagic cystitis due to cyclophosphamide (Cytoxan) and a hepatotoxic reaction to azathioprine (Imuran). During the patient's eighth admission, an increase in prednisone dosage from 7.5 to 35 mg daily had no effect on her disease one week later. She refused another increase in the dosage

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