1.Meta-analysis of randomized controlled trials for the treatment of pemphigus vulgaris and foliaceus: A comprehensive review
Inna Blanca J. Caimol ; Ma. Flordeliz Abad-Casintahan ; Ma. Cricelda Rescober-Valencia
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):33-33
BACKGROUND
Pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are rare, chronic autoimmune blistering diseases primarily treated with systemic glucocorticoids. Long-term use of glucocorticoids can result in significant adverse effects, leading to the exploration of steroid-sparing adjuvants. This meta-analysis aimed to evaluate the efficacy and safety of glucocorticoids alone versus in combination with adjuvants for treating PV and PF.
OBJECTIVEThe main objective of this study was to compare the efficacy and safety of oral glucocorticoids alone versus with steroid-sparing adjuvants in treatment of PV and PF.
METHODSThis research was a systematic review and quantitative meta-analysis of randomized controlled trials (RCTs) that compared systemic glucocorticoids with or without steroid-sparing adjuvants in treating PV and PF. A total of 20 RCTs were included after meeting the inclusion criteria, comprising 1169 patients diagnosed with PV or PF. Primary outcomes were remission rates, while secondary outcomes included relapse rates, disease control, and the occurrence of adverse events.
RESULTSStudies involving rituximab and cyclophosphamide demonstrated significantly higher remission rates compared to other adjuvants or glucocorticoid monotherapy. Adverse events were common, particularly with high-dose glucocorticoids.
CONCLUSIONSThe meta-analysis found that rituximab and cyclophosphamide were superior steroid-sparing adjuvants in the treatment of PV and PF. Other adjuvants, such as azathioprine and mycophenolate mofetil, also showed efficacy but had a higher incidence of adverse events. Further studies were needed to optimize treatment protocols and reduce long-term complications.
Meta-analysis ; Pemphigus ; Pemphigus Foliaceus ; Pemphigus Vulgaris
2.Modified autoinoculation versus curettage in the treatment of molluscum contagiosum: An assessor-blinded randomized clinical trial
Inna Blanca J. Caimol ; Agnes Espinoza-Thaebtharm ; Melanie Joy Doria-Ruiz
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):42-42
BACKGROUND
Molluscum contagiosum is a benign viral infection affecting children, sexually active adults, and immunocompromised individuals. Modified autoinoculation (MAI) is a procedure in which a solitary lesion of molluscum contagiosum lesion is inoculated in the affected skin to stimulate an immune response, thereby clearing the infection.
OBJECTIVEThis study aimed to compare the efficacy and safety of modified autoinoculation versus curettage in the treatment of molluscum contagiosum infection.
METHODSThis study was an assessor-blinded, randomized therapeutic trial performed at the Department of Dermatology of Jose R. Reyes Memorial Medical Center. 52 patients with newly diagnosed molluscum contagiosum that had not been previously treated were assigned randomly using computer-generated randomization to either curettage or MAI. 26 patients were allocated in each treatment group. Patients were followed-up every 2 weeks for 3 months and at 6 months to evaluate clearance and recurrence rates along with adverse events.
RESULTSCurettage was significantly a more effective treatment than MAI in achieving higher clearance rates and reducing recurrences. Adverse events did not differ significantly.
CONCLUSIONWhile MAI was a less invasive alternative, curettage remains superior in terms of efficacy and recurrence prevention. However, MAI may still be considered for patients seeking a less painful procedure, especially in children and those with extensive lesions.
Curettage ; Molluscum Contagiosum