Intralesional Rituximab for Recalcitrant Oral Ulcerations of Pemphigus Vulgaris

Rituximab has produced clinical and serologic remissions of pemphigus vulgaris. In some patients, disease improves but residual painful oral ulcerations endure, requiring treatment. Intralesional corticosteroids are only occasionally effective.

These authors used intralesional injections of rituximab to treat unresponsive pemphigus vulgaris–associated oral ulcerations in three patients. They had disease durations of 3.5 to 4.5 years and had received multiple systemic therapies, including one cycle of intravenous rituximab. Two patients were on oral corticosteroids, and the third was on oral azathioprine. Anti-desmoglein levels were within normal range in the two patients on corticosteroids, while the patient on azathioprine had a high level …