{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T04:43:50Z","timestamp":1793853830950,"version":"4.6.1"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T00:00:00Z","timestamp":1442275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Erythema multiforme major (<jats:styled-content style=\"fixed-case\">EMM<\/jats:styled-content>) is an inflammatory disease affecting skin and mucosae, often triggered by infection with<jats:italic>Herpes simplex virus<\/jats:italic>. Some patients have a chronic disease associated with antidesmoplakin autoantibodies, but the pathophysiology remains to be elucidated. First\u2010line treatment is antiviral therapy. With treatment failure or in patients without herpes\u2010triggered disease, thalidomide is effective but has neurological side\u2010effects. Alternatives (dapsone, immunosuppressant agents) are not codified. For many patients, systemic steroids use is chronic. The immunosuppressant drug rituximab (<jats:styled-content style=\"fixed-case\">RTX<\/jats:styled-content>) may be effective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We report five cases of severe chronic<jats:styled-content style=\"fixed-case\">EMM<\/jats:styled-content>treated with rituximab (<jats:styled-content style=\"fixed-case\">RTX<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Five patients with severe chronic<jats:styled-content style=\"fixed-case\">EMM<\/jats:styled-content>for 9\u201320\u00a0years received<jats:styled-content style=\"fixed-case\">RTX<\/jats:styled-content>after failure or side\u2010effects of several treatments, especially antiviral therapy and thalidomide. All had chronic use of steroids. Four patients had antidesmoplakin autoantibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four patients experienced complete or quasi\u2010complete remission of<jats:styled-content style=\"fixed-case\">EMM<\/jats:styled-content>with withdrawal of steroids and one patient partial remission, for 3\u201311\u00a0months. Disease relapsed in all patients, and three received a second cycle of<jats:styled-content style=\"fixed-case\">RTX<\/jats:styled-content>with shorter duration of efficacy. Two patients received a third cycle, one without efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of<jats:styled-content style=\"fixed-case\">RTX<\/jats:styled-content>for many autoimmune diseases, especially pemphigus, is increasing. Chronic<jats:styled-content style=\"fixed-case\">EMM<\/jats:styled-content>, especially<jats:styled-content style=\"fixed-case\">EMM<\/jats:styled-content>associated to antidesmoplakin autoantibodies, is an inflammatory disease in which the role of B cells is not well understood. However, we report a favourable benefit of<jats:styled-content style=\"fixed-case\">RTX<\/jats:styled-content>treatment for months in five patients with severe disease.<jats:styled-content style=\"fixed-case\">RTX<\/jats:styled-content>could be a therapeutic option in severe, difficult\u2010to\u2010treat<jats:styled-content style=\"fixed-case\">EMM<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.13313","type":"journal-article","created":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T06:29:02Z","timestamp":1442298542000},"page":"1140-1143","source":"Crossref","is-referenced-by-count":21,"title":["Rituximab, a new treatment for difficult\u2010to\u2010treat chronic erythema multiforme major? Five cases"],"prefix":"10.1111","volume":"30","author":[{"given":"G.","family":"Hirsch","sequence":"first","affiliation":[{"name":"Department of Dermatology Assistance Publique\u2010H\u00f4pitaux de Paris Henri Mondor Hospital Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ingen\u2010Housz\u2010Oro","sequence":"additional","affiliation":[{"name":"Department of Dermatology Assistance Publique\u2010H\u00f4pitaux de Paris Henri Mondor Hospital Cr\u00e9teil France"},{"name":"EA EpiDermE (Epid\u00e9miologie en Dermatologie et Evaluation des Th\u00e9rapeutiques) UPEC Cr\u00e9teil France"},{"name":"Referral center for auto\u2010immune and toxic blistering diseases, Paris Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Fite","sequence":"additional","affiliation":[{"name":"Referral center for auto\u2010immune and toxic blistering diseases, Paris Cr\u00e9teil France"},{"name":"Department of 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