{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T13:52:26Z","timestamp":1769176346545,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,10,16]],"date-time":"2013-10-16T00:00:00Z","timestamp":1381881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Intravenous immunoglobulin (<jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content>) is a potential second line of therapy for pemphigus, with increasing evidence of its effectiveness and safety, although oral corticosteroids remain the first treatment for pemphigus. <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content> is usually applied in severe cases of pemphigus, particularly pemphigus vulgaris (<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content>). Pemphigus foliaceus (<jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>) caused by immunoglobulin <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> autoantibodies to desmoglein 1 (<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>sg1) is usually milder than <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content>. However, <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> cases are occasionally resistant to corticosteroids and require long\u2010term treatment to control the disease, leading to various adverse effects. <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content> was used in patients with relatively mild <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>, who were resistant to therapies with corticosteroids and dapsone. We assessed the disease severity by Pemphigus Disease Area Index (<jats:styled-content style=\"fixed-case\">PDAI<\/jats:styled-content>) and measured anti\u2010<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>sg1 antibody indices by enzyme\u2010linked immunosorbent assay, before and 4\u00a0months after <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content>. Four Japanese female <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> patients (57.3\u00a0\u00b1\u00a08.6\u00a0years) were treated with a single cycle of <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content> (400\u00a0mg\/kg per day for five consecutive days) in combination with the previous therapies. Within 1\u20132\u00a0months of addition of <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content>, all <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> cases showed remarkable improvement of skin lesions, and <jats:styled-content style=\"fixed-case\">PDAI<\/jats:styled-content> also markedly decreased. For 2\u00a0years after <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content>, no apparent exacerbation was observed. Anti\u2010<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>sg1 antibody indices decreased in all cases during the 2\u00a0years. <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content> could be a potential treatment for not only severe cases of <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> but also mild and refractory cases of <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content> may trigger the shift from intractable condition to remission via non\u2010pathogenic anti\u2010<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>sg1 antibodies or some mechanisms excluding anti\u2010<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>sg1 antibody.<\/jats:p>","DOI":"10.1111\/1346-8138.12280","type":"journal-article","created":{"date-parts":[[2013,10,16]],"date-time":"2013-10-16T10:03:05Z","timestamp":1381917785000},"page":"869-873","source":"Crossref","is-referenced-by-count":7,"title":["Four mild but refractory cases of pemphigus foliaceus successfully treated with intravenous immunoglobulin"],"prefix":"10.1111","volume":"40","author":[{"given":"Tamihiro","family":"Kawakami","sequence":"first","affiliation":[{"name":"Department of Dermatology Kurume University School of Medicine Kurume University Institute of Cutaneous Cell Biology Kurume Fukuoka Japan"},{"name":"Department of Dermatology St Marianna University School of Medicine Kawasaki Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Koga","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kurume University School of Medicine Kurume University Institute of Cutaneous Cell Biology Kurume Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Saruta","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kurume University School of Medicine Kurume University Institute of Cutaneous Cell Biology Kurume Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kurume University School of Medicine Kurume University Institute of Cutaneous Cell Biology Kurume Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiko","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kurume University School of Medicine Kurume University Institute of Cutaneous Cell Biology Kurume Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinao","family":"Soma","sequence":"additional","affiliation":[{"name":"Department of 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