{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:44:44Z","timestamp":1788997484251,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pediatric pemphigus is a rare bullous disease that represents\u00a0a diagnostic and therapeutic challenge; \u00a0evidence on patients' response to various treatments and long\u2010term surveillance data are lacking. We aimed to investigate pediatric pemphigus patients' characteristics, diagnosis, therapeutics, response, and long\u2010term follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective study of all pemphigus patients aged &lt;18\u2009years, diagnosed between 2000 and 2023, from three tertiary medical centers in Israel. The diagnosis was confirmed by positive immunofluorescence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve pediatric pemphigus patients were included (mean age 10.7\u2009\u00b1\u20094.3\u2009years, male:female ratio 1:1). Mean diagnostic delay was 11.1\u2009\u00b1\u200912.6\u2009months (range 1.8\u201336\u2009months). Most patients had pemphigus vulgaris with mucosal involvement (58.3%). First\u2010line treatment for all patients included systemic corticosteroids (sCS), with a treatment duration (including tapering down) of 28\u2009\u00b1\u200918.4\u2009months. Hospitalization did not yield better outcomes. Only three patients achieved sustained complete response with sCS treatment (25.0%), and the rest required additional therapeutics, most commonly rituximab. Rituximab showed a good safety profile and therapeutic response. Follow\u2010up was recorded up to 18.1\u2009years after diagnosis (mean: 5.6\u2009years). Three of five patients with information available more than 5\u2009years after the pemphigus diagnosis still exhibited disease symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pediatric pemphigus is associated with a significant diagnostic delay. While sCS can induce remission in most patients as a first\u2010line treatment, long\u2010term disease control requires additional immunomodulators. Long\u2010term follow\u2010up reveals a chronic yet mostly benign disease course in this population and advocates for the use of rituximab in pediatric pemphigus patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijd.17251","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T07:54:21Z","timestamp":1717142061000},"page":"1755-1760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnosis, treatment, and long\u2010term outcomes of pediatric pemphigus: a retrospective study at tertiary medical centers"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2876-3048","authenticated-orcid":false,"given":"Yael","family":"Renert\u2010Yuval","sequence":"first","affiliation":[{"name":"Pediatric Dermatology Unit Schneider Children's Medical Center of Israel  Petah Tikva Israel"},{"name":"Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Baum","sequence":"additional","affiliation":[{"name":"Tel Aviv University  Tel Aviv Israel"},{"name":"Pediatric Dermatology Unit, Department of Dermatology Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8308-2790","authenticated-orcid":false,"given":"Shoshana","family":"Greenberger","sequence":"additional","affiliation":[{"name":"Tel Aviv University  Tel Aviv Israel"},{"name":"Pediatric Dermatology Unit, Department of Dermatology Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Cohen\u2010Barak","sequence":"additional","affiliation":[{"name":"Department of Dermatology HaEmek Medical Center  Afula Israel"},{"name":"Technion's Rappaport Faculty of Medicine  Haifa 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