Infection and Infection Prevention in Patients Treated with Immunosuppressive Medications for Autoimmune Bullous Disorders

Dermatologic Clinics

Volumn 29, Issue 4, 2011, Pages 591-598

  Lehman, Julia S ^a   Murrell, Dédée F ^b   Camilleri, Michael J ^a   Kalaaji, Amer N ^a  

^a MAYO CLINIC   (United States)

^b UNIVERSITY OF NEW SOUTH WALES   (Australia)

Author keywords

Immunization; Immunobullous disease; Immunosuppressive medication; Infection; Vaccination; Wound healing

Indexed keywords

ACICLOVIR; ANTIBIOTIC AGENT; ATOVAQUONE; CHLORHEXIDINE GLUCONATE; CORTICOSTEROID; COTRIMOXAZOLE; DAPSONE; DIPHTHERIA PERTUSSIS TETANUS VACCINE; DIPHTHERIA TETANUS VACCINE; DOXYCYCLINE; HEPATITIS A VACCINE; HEPATITIS B VACCINE; INFLUENZA VACCINE; MENINGOCOCCUS VACCINE; PENTAMIDINE; PNEUMOCOCCUS VACCINE; PSEUDOMONIC ACID; RIFAMPICIN; VALACICLOVIR; VARICELLA ZOSTER VACCINE; WART VIRUS VACCINE;

AUTOIMMUNE BULLOUS DISEASE; AUTOIMMUNE SKIN DISEASE; BACTERIAL COLONIZATION; BACTERIAL SKIN DISEASE; BLOOD GLUCOSE MONITORING; CELLULITIS; CONSERVATIVE TREATMENT; DIPHTHERIA; DISEASE ASSOCIATION; DRUG MEGADOSE; ERYTHEMA; FUNGAL COLONIZATION; HEPATITIS A; HEPATITIS B; HERPES SIMPLEX; HERPES ZOSTER; HUMAN; IMMUNOSUPPRESSIVE TREATMENT; INFECTION PREVENTION; INFLUENZA; KAPOSI SARCOMA; MENINGOCOCCOSIS; MICROBIAL COLONIZATION; MYCOBACTERIOSIS; MYCOSIS; NUTRITIONAL STATUS; PAPILLOMAVIRUS INFECTION; PATIENT EDUCATION; PEMPHIGUS VULGARIS; PERTUSSIS; PNEUMOCYSTIS PNEUMONIA; POSTHERPETIC NEURALGIA; PRIMARY PREVENTION; PRIORITY JOURNAL; REVIEW; SECONDARY PREVENTION; SKIN EDEMA; SKIN INFECTION; SMOKING CESSATION; STREPTOCOCCUS PNEUMONIA; TETANUS; VIRAL COLONIZATION; VIRAL SKIN DISEASE; WOUND DRESSING;

AUTOIMMUNE DISEASES; BACTERIAL INFECTIONS; FEMALE; HUMANS; IMMUNOSUPPRESSIVE AGENTS; MALE; MYCOSES; SKIN DISEASES, VESICULOBULLOUS; TREATMENT OUTCOME; VIRUS DISEASES;

EID: 80052885309     PISSN: 07338635     EISSN: 15580520     Source Type: Journal    
DOI: 10.1016/j.det.2011.06.021     Document Type: Review

References (53)

1. Langan S.M., Hubbard R., Fleming K., et al. A population-based study of acute medical conditions associated with bullous pemphigoid. Br J Dermatol 2009, 161(5):1149-1152.
2. Savin J.A., Noble W.C. Immunosuppression and skin infection. Br J Dermatol 1975, 93(1):115-120.
3. Ahmed A.R., Moy R. Death in pemphigus. J Am Acad Dermatol 1982, 7(2):221-228.
4. Wysocki A.B. Evaluating and managing open skin wounds: colonization versus infection. AACN Clin Issues 2002, 13(3):382-397.
5. Mitchell S.R., Nguyen P.Q., Katz P. Increased risk of neisserial infections in systemic lupus erythematosus. Semin Arthritis Rheum 1990, 20(3):174-184.
6. Robson M.C. Wound infection: a failure of wound healing caused by an imbalance of bacteria. Surg Clin North Am 1997, 77(3):637-650.
7. Boughrara Z., Ingen-Housz-Oro S., Legrand P., et al. Cutaneous infections in bullous pemphigoid patients treated with topical corticosteroids. Ann Dermatol Venereol 2010, 137(5):345-351.
8. Belgnaoui F.Z., Senouci K., Chraibi H., et al. Predisposition to infection in patients with pemphigus. Retrospective study of 141 cases. Presse Med 2007, 36(11 Pt 1):1563-1569.
9. Asilian A., Yoosefi A., Faghihi G. Cutaneous and pulmonary nocardiosis in pemphigus vulgaris: a rare complication of immunosuppressive therapy. Int J Dermatol 2006, 45(10):1204-1206.
10. Akyol M., Ozçelik S., Engin A., et al. A case with Listeria meningitis during administration of mycophenolate mofetil for pemphigus vulgaris. J Eur Acad Dermatol Venereol 2007, 21(10):1447-1448.
11. Garg G., Thami G.P. Enterococcal bacteremia complicating pemphigus vulgaris: successful treatment with linezolid. J Dermatol 2004, 31(7):580-581.
12. Sood S., Nerurkar V., Malvankar S. Chryseobacterium meningosepticum cellulitis and sepsis in an adult female with pemphigus vulgaris. Indian J Med Microbiol 2010, 28(3):268-269.
13. Ruocco V., Wolf R., Ruocco E., et al. Viruses in pemphigus: a casual or causal relationship?. Int J Dermatol 1996, 35(11):782-784.
14. Feldmeyer L., Trüeb R.M., French L.E., et al. Pitfall: pemphigus herpeticatus should not be confounded with resistant pemphigus vulgaris. J Dermatolog Treat 2010, 21(5):311-313.
15. Marzano A.V., Tourlaki A., Merlo V., et al. Herpes simplex virus infection and pemphigus. Int J Immunopathol Pharmacol 2009, 22(3):781-786.
16. Nikkels A.F., Delvenne P., Herfs M., et al. Occult herpes simplex virus colonization of bullous dermatitides. Am J Clin Dermatol 2008, 9(3):163-168.
17. Avalos-Peralta P., Herrera A., Ríos-Martín J.J., et al. Localized Kaposi's sarcoma in a patient with pemphigus vulgaris. J Eur Acad Dermatol Venereol 2006, 20(1):79-83.
18. Meibodi N.T., Nahidi Y., Mahmoudi M., et al. Evaluation of coexistence of the human herpesvirus type 8 (HHV-8) infection and pemphigus. Int J Dermatol 2010, 49(7):780-783.
19. Halpern S.M., Parslew R., Cerio R., et al. Kaposi's sarcoma associated with immunosuppression for bullous pemphigoid. Br J Dermatol 1997, 137(1):140-143.
20. Yang C.H., Wu T.S., Chiu C.T. Chronic hepatitis B reactivation: a word of caution regarding the use of systemic glucocorticosteroid therapy. Br J Dermatol 2007, 157(3):587-590.
21. Hsiao G.H., Chiu H.C. Dermatophyte infection associated with a local recurrence of bullous pemphigoid. Br J Dermatol 1995, 132(5):833-835.
22. Galimberti R.L., Flores V., Gonzalez Ramos M.C., et al. Cutaneous ulcers due to Candida albicans in an immunocompromised patient-response to therapy with itraconazole. Clin Exp Dermatol 1989, 14(4):295-297.
23. Guenova E., Hoetzenecker W., Schaller M., et al. Tinea incognito hidden under apparently treatment-resistant pemphigus foliaceus. Acta Derm Venereol 2008, 88(3):276-277.
24. Tuchinda P., Boonchai W., Prukpaisarn P., et al. Prevalence of onychomycosis in patients with autoimmune diseases. J Med Assoc Thai 2006, 89(8):1249-1252.
25. Green H., Paul M., Vidal L., et al. Prophylaxis of pneumocystis pneumonia in immunocompromised non-HIV-infected patients: systematic review and meta-analysis of randomized controlled trials. Mayo Clin Proc 2007, 82(9):1052-1059.
26. Yale S.H., Limper A.H. Pneumocystis carinii pneumonia in patients without acquired immunodeficiency syndrome: associated illness and prior corticosteroid therapy. Mayo Clin Proc 1996, 71(1):5-13.
27. Gerhart J.L., Kalaaji A.N. Development of Pneumocystis carinii pneumonia in patients with immunobullous and connective tissue disease receiving immunosuppressive medications. J Am Acad Dermatol 2010, 62(6):957-961.
28. Lehman J.S., Kalaaji A.N. Role of primary prophylaxis for pneumocystis pneumonia in patients treated with systemic corticosteroids or other immunosuppressive agents for immune-mediated dermatologic conditions. J Am Acad Dermatol 2010, 63(5):815-823.
29. Adachi M., Tsuruta D., Imanishi H., et al. Necrotizing fasciitis caused by Cryptococcus neoformans in a patient with pemphigus vegetans. Clin Exp Dermatol 2009, 34(8):e751-e753.
30. Yoo S.S., Tran M., Anhalt G., et al. Disseminated cellulitic cryptococcosis in the setting of prednisone monotherapy for pemphigus vulgaris. J Dermatol 2003, 30(5):405-410.
31. Uslan D.Z., Kowalski T.J., Wengenack N.L., et al. Skin and soft tissue infections due to rapidly growing mycobacteria: comparison of clinical features, treatment, and susceptibility. Arch Dermatol 2006, 142(10):1287-1292.
32. Barnadas M., Roe E., Brunet S., et al. Therapy of paraneoplastic pemphigus with rituximab: a case report and review of literature. J Eur Acad Dermatol Venereol 2006, 20(1):69-74.
33. Nanda A., Nanda M., Dvorak R., et al. Bullous pemphigoid (BP) in an infant complicated by tuberculous meningoencephalitis. Int J Dermatol 2007, 46(9):964-966.
34. Kawabata E., Morita K., Matsuyoshi N., et al. Bilateral inguinal scrofuloderma during steroid therapy in a patient with bullous pemphigoid. J Dermatol 1995, 22(8):582-586.
35. Wallis R.S. Tumour necrosis factor antagonists: structure, function, and tuberculosis risks. Lancet Infect Dis 2008, 8(10):601-611.
36. Tingström P., Milberg A., Sund-Levander M. Early nonspecific signs and symptoms of infection in institutionalized elderly persons: perceptions of nursing assistants. Scand J Caring Sci 2010, 24(1):24-31.
37. Huang J.T., Rademaker A., Paller A.S. Dilute bleach baths for Staphylococcus aureus colonization in atopic dermatitis to decrease disease severity. Arch Dermatol 2011, 147(2):246-247.
38. Craig F.E., Smith E.V., Williams H.C. Bleach baths to reduce severity of atopic dermatitis colonized by Staphylococcus. Arch Dermatol 2010, 146(5):541-543.
39. Bottone E.J., Perez A.A., Oeser J.L. Loofah sponges as reservoirs and vehicles in the transmission of potentially pathogenic bacterial species to human skin. J Clin Microbiol 1994, 32(20):469-472.
40. Wolcott R.D., Kennedy J.P., Dowd S.E. Regular debridement is the main tool for maintaining a healthy wound bed in most chronic wounds. J Wound Care 2009, 18(2):54-56.
41. Lipsky B.A., Hoey C. Topical antimicrobial therapy for treating chronic wounds. Clin Infect Dis 2009, 49(10):1541-1549.
42. Simor A.E., Phillips E., McGeer A., et al. Randomized controlled trial of chlorhexidine gluconate for washing, intranasal mupirocin, and rifampin and doxycycline versus no treatment for the eradication of methicillin-resistant Staphylococcus aureus colonization. Clin Infect Dis 2007, 44(2):178-185.
43. Harbarth S., Dharan S., Liassine N., et al. Randomized, placebo-controlled, double-blind trial to evaluate the efficacy of mupirocin for eradicating carriage of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 1999, 43(6):1412-1416.
44. Recommended adult immunization schedule - United States. MMWR Morb Mortal Wkly Rep 2011, 60(4):1-4. Centers for Disease Control and Prevention, Available at:, Accessed April 20, 2011. http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/mmwr-adult-schedule.pdf.
45. Avery R.K., Michaels M. Update on immunizations in solid organ transplant recipients: what clinicians need to know. Am J Transplant 2008, 8(1):9-14.
46. Haroon M., Adeeb F., Eltahir A., et al. The uptake of influenza and pneumococcal vaccination among immunocompromised patients attending rheumatology outpatient clinics. Joint Bone Spine 2011, 78(4):374-377.
47. Yeung J.H., Goodman K.J., Fedorak R.N. Inadequate knowledge of immunization guidelines: a missed opportunity for preventing infection in immunocompromised IBD patients. Inflamm Bowel Dis 2011, [Epub ahead of print]. 10.1002/ibd.21668.
48. Fiore A.E., Uyeki T.M., Broder K., et al. General recommendations on immunization - recommendations of the Advisory Committee on Immunization Practices (ACIP). National Center for Immunization and Respiratory Diseases. MMWR Recomm Rep 2011, 60(2):1-64.
49. Harpaz R., Ortega-Sanchez I.R., Seward J.F. Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2008, 57(RR-5):1-30.
50. Grewal P., Brassard A. Fact or fiction: does the non-HIV/AIDS immunosuppressed patient need Pneumocystis jiroveci pneumonia prophylaxis? An updated literature review. J Cutan Med Surg 2009, 13(6):308-312.
51. Pneumocystis jiroveci pneumonia treatment and prevention. Medical Letter. Available at: Accessed April 20, 2011. http://dpd.cdc.gov/dpdx/HTML/PDF_Files/MedLetter/Pneumocystis_jiroveci.pdf.
52. Fillet A.M. Prophylaxis of herpesvirus infections in immunocompetent and immunocompromised older patients. Drugs Aging 2002, 19(5):343-354.
53. Chan Y.C., Yosipovitch G. Suggested guidelines for screening and management of tuberculosis in patients taking oral glucocorticoids-an important but often neglected issue. J Am Acad Dermatol 2003, 49(1):91-95.