Intravenous immunoglobulin as an effective treatment for refractory pemphigus vegetans: A case report
Abdullah Moktar 1 , Shada Alanazi 2 , Sarah Anwar Almulla 2 * , Mai Saadoon Alsaadoon 2
More Detail
1 Section of Dermatology, Department of Internal Medicine, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Al-Ahsa, SAUDI ARABIA2 College of Medicine, King Faisal University, Al-Ahsa, SAUDI ARABIA* Corresponding Author

Abstract

Pemphigus vegetans (PVeg), which affects < 2% of pemphigus cases, presents a therapeutic challenge when refractory to conventional treatments. Herein, we describe the case of a 58-year-old woman diagnosed with Hallopeau-type PVeg who demonstrated a complete response to intravenous immunoglobulin (IVIG) after failing multiple conventional therapies. The patient exhibited vegetative plaques at multiple sites, with notable nail involvement. Her disease remained poorly controlled despite a 7-year course of systemic corticosteroids, immunosuppressants, and rituximab. Two courses of IVIG (5% concentration, 2 g/kg) resulted in the complete resolution of the disease. This case highlights IVIG’s therapeutic potential in refractory PVeg and emphasizes the importance of recognizing atypical manifestations, including nail involvement. While this single case yielded promising results, future studies must validate the role of IVIG in the management of treatment-resistant PVeg.

License

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Case Report

ELECTRON J GEN MED, Volume 22, Issue 4, August 2025, Article No: em667

https://doi.org/10.29333/ejgm/16518

Publication date: 01 Jul 2025

Online publication date: 18 Jun 2025

Article Views: 122

Article Downloads: 91

Open Access References How to cite this article