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Background <p>Erythrodermic pemphigus foliaceus (EPF) is a severe, often refractory autoimmune disease.</p> Method <p>We report successful treatment of refractory EPF in a 59-year-old male using low-dose rituximab (RTX) and intravenous immunoglobulin (IVIG).</p> Results <p>Initial high-dose corticosteroids and IVIG failed, complicated by infections. A modified regimen of RTX (0.5 g) and IVIG (0.4 g/kg/day for three days) every two weeks for two cycles induced remission, with a mild relapse at six months successfully retreated. No infections occurred during 15-month follow-up.</p> Conclusion <p>This combined therapy using low-dose RTX and IVIG may be a safe and effective option for refractory EPF, potentially minimizing infection risk associated with standard RTX dosing. Further studies are warranted.</p>

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Successful treatment of refractory erythrodermic pemphigus foliaceus with low-dose rituximab and intravenous immunoglobulin

  • 期刊论文

  • 发表日期：

    2025年6月3日

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  • Jiawen Zhang,
  • Chengfeng Zhang,
  • Zhongyi Xu,
  • Jun Liang,
  • Qinyuan Zhu

摘要

Background

Erythrodermic pemphigus foliaceus (EPF) is a severe, often refractory autoimmune disease.

Method

We report successful treatment of refractory EPF in a 59-year-old male using low-dose rituximab (RTX) and intravenous immunoglobulin (IVIG).

Results

Initial high-dose corticosteroids and IVIG failed, complicated by infections. A modified regimen of RTX (0.5 g) and IVIG (0.4 g/kg/day for three days) every two weeks for two cycles induced remission, with a mild relapse at six months successfully retreated. No infections occurred during 15-month follow-up.

Conclusion

This combined therapy using low-dose RTX and IVIG may be a safe and effective option for refractory EPF, potentially minimizing infection risk associated with standard RTX dosing. Further studies are warranted.