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In autoimmune bullous diseases, IVIGs can be used in an adjuvant setting (second\u2010 or third\u2010line therapy) once combined immunosuppressive regimens have failed. In dermatomyositis, IVIGs may already be employed as an adjuvant second\u2010line therapy after failure of corticosteroid monotherapy. In scleromyxedema, IVIGs may be considered as first\u2010line treatment, given the lack of effective and safe alternatives. Other potential indications for IVIGs may include severe recalcitrant cases of systemic vasculitis and systemic lupus erythematosus. Toxic epidermal necrolysis may be an indication for high\u2010dose IVIGs if administered early. Common, readily manageable side effects include nausea, headache, fatigue, and febrile infusion reactions. Severe adverse events such as thromboembolic events, anaphylaxis, and acute renal failure are very uncommon. The risk of viral transmission is very low. Potential mechanisms of action include upregulation of inhibitory Fc receptors, reduction of the half\u2010life of endogenous immunoglobulins due to displacement from protective receptor sites, neutralization of autoantibodies by anti\u2010idiotypic antibodies, as well as inhibition of complement activation.<\/jats:p>","DOI":"10.1111\/ddg.13389","type":"journal-article","created":{"date-parts":[[2017,12,11]],"date-time":"2017-12-11T19:50:32Z","timestamp":1513021832000},"page":"1211-1226","source":"Crossref","is-referenced-by-count":8,"title":["High\u2010dose intravenous immunoglobulins for the treatment of dermatological autoimmune diseases"],"prefix":"10.1111","volume":"15","author":[{"given":"Jochen H.O.","family":"Hoffmann","sequence":"first","affiliation":[{"name":"Department of Dermatology University of Heidelberg  Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander 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