Treatments for Bullous Pemphigoid
Treatments for Bullous Pemphigoid
The list of treatments mentioned in various sources
for Bullous Pemphigoid
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Bullous Pemphigoid: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Bullous Pemphigoid may include:
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Bullous Pemphigoid: Research Doctors & Specialists
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Unlabeled Drugs and Medications to treat Bullous Pemphigoid:
Unlabelled alternative drug treatments for Bullous Pemphigoid include:
- Immune Globulin (intravenous)
- Carimune
- Carimune NF
- Flebogamma
- Gamimune N
- Gammagard S/D
- Gammar-P
- Gamunex
- Iveegam EN
- Octagam
- Panglobulin
- Panglobulin NF
- Polygam S/D
- Iveegam Immuno
- Cilax
- Intacglobin
- Sandoblobulina
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Book Excerpts: Treatment of Bullous Pemphigoid
Treatments of Bullous Pemphigoid: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about the treatments of Bullous Pemphigoid.
Vesicular & Bullous Lesions:
Treatment
(In a Page: Signs and Symptoms)
-
HSV-1, HSV-2, and HZV can be effectively treated with antiviral medication (e.g., acyclovir, famciclovir). Early antiviral therapy may decrease the risk of post-herpetic neuralgia. HSV is infectious until all cutaneous lesions have crusted over
-
Bullous impetigo can be treated with topical mupirocin, or systemic antibiotics (e.g., erythromycin, cephalexin)
-
Dyshidrotic eczema can be difficult to treat. It is not curable, but can be controlled with high-potency topical steroid ointments and heavy emollients
-
PMLE is preventable with sun avoidance and zinc- or titanium-based sun blocks. Topical steroids can diminish the pruritus that accompanies an episode
-
SJS/TEN treatment consists of supportive care and discontinuing the offending drug, often requiring a burn center; IVIG and systemic steroids are sometimes used.
-
Systemic immunosuppressants (e.g., prednisone, cyclosporin, azathioprine) are often necessary to control autoimmune bullous diseases like pemphigus
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Atopic dermatitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Measures to ease this chronic disorder include meticulous skin care, environmental control of offending allergens, and drug therapy. Because dry skin aggravates itching, frequent application of nonirritating topical lubricants is important, especially after bathing or showering. Minimizing exposure to allergens and irritants, such as wools and harsh detergents, also helps control symptoms.
Drug therapy involves corticosteroids and antipruritics. Active dermatitis responds well to topical corticosteroids, which should be applied immediately after bathing for optimal penetration. Oral antihistamines are commonly used to help control itching. A bedtime dose may reduce involuntary scratching during sleep. If secondary infection develops, antibiotics are necessary. A newer treatment is the use of topical immunomodulators; these agents are steroid-free and have demonstrated an 80% success rate in studies.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Dermatitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Effective treatment for atopic lesions consists of eliminating allergens and avoiding irritants, extreme temperature and humidity changes, and other precipitating factors; local and systemic measures relieve itching and inflammation. Antihistamines relieve itching and induce more restful sleep. Topical application of a corticosteroid ointment, especially after bathing, often alleviates inflammation. Between steroid doses, application of a moisturizing cream can help retain moisture. Systemic corticosteroid therapy should be used only during extreme exacerbations. Topical tacrolimus and pimecrolimus (an immunosuppressant known as a topical immunomodulator) are new agents used in patients older than age 2 who are intolerant of or unresponsive to conventional therapy. Weak tar preparations and ultraviolet B light therapy are used to increase the thickness of the stratum corneum. Antibiotics are appropriate if a bacterial agent has been cultured.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Dermatitis:
Treatment
(Handbook of Diseases)
Effective treatment of atopic lesions consists of eliminating allergens and avoiding irritants (strong soaps, cleansers, and other chemicals), extreme temperature changes, and other precipitating factors. Local and systemic measures relieve itching and inflammation.
Clinical tip Prevention of excessive dryness of the skin is critical to successful therapy.
Topical application of a cortico-steroid ointment, especially after bathing, usually alleviates inflammation. Between steroid doses, application of a moisturizing cream can help retain moisture. Systemic corticosteroid therapy should be used only during extreme exacerbations.
Weak tar preparations and ultraviolet B light therapy are used to increase the thickness of the stratum corneum. Antibiotics are appropriate for crusted and weeping lesions.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Cough - Case 4-2: 7-Week-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
As mentioned, infants with small VSDs usually do not require any intervention.
They do require careful surveillance during the first 6 months of life, to
assess growth and respiratory status. Many of these small VSDs close
spontaneously. Importantly, these patients still require endocarditis
prophylaxis.
Usually, those infants with moderate or large VSDs develop some degree of
congestive heart failure. Medical management is often the initial therapy and
may include furosemide, chlorothiazide, spironolactone, and digoxin. On
occasion, afterload reduction with captopril is also required. In those
patients with persistent failure to thrive, caloric augmentation may be
required. If the patient
's congestive heart failure and growth failure are not controlled with medical
management, surgical intervention is required.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Cough - Case 4-3: 7-Month-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
In uncomplicated measles, patients require only supportive care, including
antipyretics and fluids. Antibiotics are necessary only in cases of bacterial
superinfection, particularly pneumonia. Typical organisms causing a
superinfected bacterial pneumonia include
Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pyogenes.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Cough - Case 4-6: 4-Month-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Because young infants with pertussis have a high risk for complications, there
should be a low threshold for admitting these patients. Many of these infants
require admission to the intensive care unit to monitor for apneic episodes and
neurologic sequelae.
Infants should be treated with a macrolide antibiotic, and erythromycin is the
most common choice. The length of therapy is generally recommended to be 14
days. Azithromycin and clarithromycin appear to be effective as well. There is
some controversy as to whether antibiotics given during the catarrhal stage
decrease disease severity. However, antibiotics should still be given, even in
the paroxysmal stage, because they limit the spread of the disease to others.
Studies are underway to assess the efficacy of pertussis immune globulin as an
adjunctive therapy in extremely ill infants.
Antibiotic prophylaxis is recommended for all household members and close
contacts and usually consists of 10 to 14 days of erythromycin. Prevention is
essential to limit the morbidity and mortality from pertussis, and the
acellular pertussis vaccine is currently the recommended form. It is given in
combination with diphtheria and tetanus toxoids (DTaP). It is recommended that
children receive five doses before school entry.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Diarrhea - Case 17-1: 2-Month-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
In cases of incarcerated hernia, time is of the essence. Compromised blood flow
to the affected loop of bowel can result in strangulation and bowel necrosis
within 2 hours, so medical intervention is necessary. Reduction of the
incarcerated hernia by experienced pediatric surgical staff is optimal. A
gentle attempt at reduction using pressure on the scrotum with simultaneous
counterpressure above the external inguinal ring is indicated but should never
be forcefully done. Intravenous hydration and nasogastric tube decompression,
in anticipation of definitive surgical management, are also indicated.
Emergency surgery is sometimes required if the incarcerated hernia is not
reducible. If the incarcerated loop of bowel is reduced, surgery may be
postponed 12 to 36 hours so that the bowel edema can resolve.
Elective repair of an asymptomatic inguinal hernia should be performed as soon
as possible after diagnosis, to avoid complications such as incarceration. All
inguinal hernias require surgical intervention, because they do not resolve
spontaneously. In boys, undescended testes may be associated with inguinal
hernia, requiring orchiopexy. There is still some debate as to the importance
of surgical exploration of the contralateral side in search of an occult
inguinal hernia not detected by physical examination, as was the case in this
patient. This decision is left to the individual surgeon, but contralateral
exploration is commonly performed.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Diarrhea - Case 17-4: 15-Month-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Surgical resection is usually performed. Low-risk patients may not need any
additional therapy. Radiotherapy and chemotherapy are used, depending on the
stage of the disease. Patients with high-risk disease may have some improvement
in short-term survival with autologous bone marrow transplantation, but
longer-term outcome is still poor. Surgical removal of the tumor usually cures
the secretory diarrhea. The use of somatostatin analogues also has a
therapeutic effect on the secretory diarrhea, but the definitive therapy for
the diarrhea remains surgical.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Fever - Case 11-1: 18-Month-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
No specific therapy is currently available. In the future, targeted therapies
for NF1-associated tumors may be designed to inhibit growth-promoting pathways
activated in the absence of neurofibromin. Other potential therapies focus on
blockade of angiogenic factors that could potentially decrease tumor growth.
Routine office visits should focus on detection and management of complications,
as discussed previously. Annual ophthalmologic examinations are important to
detect optic nerve lesions. Interval history should focus on subtle sensory or
motor symptoms such as paresthesia or muscle atrophy. Pediatricians should also
inquire about incontinence, given the risk of spinal cord neurofibromas.
Consultation with specific surgical specialists is warranted based on the
location of neurofibromas. Laser treatment has not yet proved successful in
permanently removing caf
é-au-lait spots.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Fever - Case 11-4: 7-Month-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Most patients require only appropriate antibiotic therapy to treat bacterial
infections as they occur. Prophylactic antibiotics are not routinely used,
because the efficacy of such prophylaxis is unclear. Some patients benefit from
antibacterial mouthwashes for occasional mouth sores and gingivitis. G-CSF,
corticosteroids, and intravenous gammaglobulin administration are not routinely
required but have been used to increase neutrophil counts in patients with
serious or recurrent infections (15% of patients with AIN in infancy). In such cases, approximately
50% of children respond to corticosteroids and 75% respond to gammaglobulin.
G-CSF is effective in almost all patients. The neutropenia resolves
spontaneously in 95% of patients, usually within 7 to 24 months. Disappearance
of autoantibodies precedes spontaneous normalization of the neutrophil count.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Jaundice - Case 15-1: 14-Day-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
The removal of galactose from the diet remains the first principle of therapy
for galactosemia. The exclusion of milk (including breast milk) and dairy
products is necessary for the patient
's lifetime.
Depending on the degree of illness at the time of presentation, galactosemic
neonates often require supportive care measures such as intravenous fluids and
antibiotics. Liver synthetic function may be compromised, and the sick infant
may require supplemental vitamin K or even transfusion of fresh-frozen plasma.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Jaundice - Case 15-3: 2-Month-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Replacement of the hormones produced by the pituitary's target organs is the cornerstone of hypopituitarism therapy. Thyroid hormone
replacement should begin as soon as confirmatory testing is completed; delays
in therapy can result in increased risk of cognitive impairment. Jaundice
improves as the underlying endocrine disorder is treated.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Jaundice - Case 15-4: 6-Week-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
The hepatic portoenterostomy (Kasai procedure) for biliary atresia involves the
anastomosis of a limb of small intestine to hepatic ducts in the region of the
porta hepatis (where the portal vein and hepatic artery enter the liver and the
hepatic ducts exit). It relies on the patency of tiny duct remnants to allow
for bile drainage from the liver. Cholangitis is among the most worrisome of
the postoperative complications of hepatic portoenterostomy; its signs and
symptoms include fever, diminished bile flow, and the return of
hyperbilirubinemia. Over time, survivors of hepatic portoenterostomy are also
at risk for liver dysfunction, portal hypertension, esophageal varices,
hypersplenism, and hepatopulmonary syndrome, in which arteriovenous shunts form
within the lung. Liver transplantation is often required for patients who have
undergone portoenterostomy for EHBA, and it is sometimes necessary as a primary
operation if liver disease is far advanced at the time of diagnosis. Estimates
of 10-year survival for patients with EHBA range from 40% to 70%. Approximately
25% to 40% of patients survive 10 years without requiring transplantation.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Jaundice - Case 15-6: 5-Week-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Treatment of Alagille syndrome focuses on the medical management of cholestasis,
promotion of growth and development, and treatment of any comorbidities (e.g.,
congenital heart disease). Children with Alagille syndrome suffer from
malabsorption and require supplementation of fat-soluble vitamins and provision
of sufficient calories for growth, which may necessitate tube feeding. Infants
should receive formulas containing medium-chain triglycerides, which are
absorbable without bile salts. Medications that may benefit Alagille patients
(for example, by promoting bile flow or reducing pruritus) include
phenobarbital, cholestyramine, ursodeoxycholic acid, and antihistamines.
Long-term follow-up of patients with Alagille syndrome includes monitoring for
the development of cirrhosis, portal hypertension, ascites, and liver failure.
The 20-year life expectancy for patients with Alagille syndrome is about 75%
overall, although rates are lower for those patients who require liver
transplantation and for those with severe associated abnormalities (e.g.,
congenital heart disease).
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Pallor - Case 10-1: 3-Week-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
The treatment includes use of corticosteroids. The currently recommended dose is
2 mg/kg per day of prednisone, given in three or four divided doses.
Reticulocytes appear within 1 to 2 weeks, but the rise in hemoglobin is delayed
for several more weeks. Once the hemoglobin level reaches 10 g/dL, the steroid
dose is gradually tapered until the patient is receiving a single daily dose
that adequately maintains appropriate hemoglobin levels. Response followed by
steroid dependence is seen in 60% of patients. Approximately one fifth of the
steroid-responsive patients may ultimately be maintained without steroids.
Approximately 30% to 40% of patients have poor or no response to steroids and
require chronic transfusion therapy to maintain normal hemoglobin. These
children require leukocyte-depleted packed RBC transfusions every 3 to 6 weeks,
with the goal of keeping the hemoglobin level higher than 6 g/dL. Concurrent
chelation of iron with subcutaneously administered desferrioxamine may decrease
some chronic transfusion-related complications. Complications of chronic
transfusion therapy are similar to those seen with other conditions that employ
this modality (e.g., thalassemia). Bone marrow transplantation has been
successful for some patients.
Median survival time is 43 years, but approximately 13% of patients die within
the first 6 years of life. Deaths occur from complications of iron overload,
pneumonia, sepsis, and occasionally transplant-related complications, leukemia,
and pulmonary emboli.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Pallor - Case 10-2: 12-Month-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Treatment of iron deficiency depends on its cause. For children with suspected
dietary deficiency, treatment consists of supplemental iron. In children with
anemia, an initial therapeutic trial often eliminates the need for expensive
laboratory testing in determining the diagnosis. The reticulocyte count usually
increases within several days and the hemoglobin concentration within 3 weeks.
Patients should be treated until the hemoglobin reaches the normal range and
then for at least one additional month to replete the iron stores. Failure of
the hemoglobin level to rise within 1 month indicates either poor compliance
with iron therapy or incorrect diagnosis.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Pallor - Case 10-3: 5-Month-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
The mainstay of treatment is corticosteroids, given at a dosage of 2 to 10 mg/kg
per day. In severely ill patients such as this child, the steroids should be
given intravenously. Otherwise, the care is supportive and includes replacement
therapy. Compatible cross-matching may not be possible, but if the patient is
in extremis blood type group O, Rh-negative blood should be used in aliquots
that are given slowly and in amounts sufficient to stabilize the cardiovascular
system. The patient should be adequately hydrated to avoid renal involvement.
Splenectomy may be necessary if steroid therapy fails.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Rash - Case 9-2: 7-Week-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
The injuries suffered by the child should be managed as medically indicated. The
state division of child and family services should be notified in all cases of
suspected abuse. Removal from the home and placement in foster care may be
required. In this case, once the child was removed from the home, no additional
lesions were noted.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
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