학술논문

Diagnosis and management of pemphigus: Recommendations of an international panel of experts
Document Type
article
Source
Journal of the American Academy of Dermatology. 82(3)
Subject
Academies and Institutes
Administration
Intravenous
Antigens
CD20
Combined Modality Therapy
Consensus
Delphi Technique
Dermatology
Drug Therapy
Combination
Europe
Glucocorticoids
Humans
Immunologic Factors
Pemphigus
Plasmapheresis
Practice Guidelines as Topic
Rituximab
Severity of Illness Index
CD20 inhibitor
consensus
guidelines
pemphigus foliaceus
pemphigus vulgaris
treatment
Clinical Sciences
Dermatology & Venereal Diseases
Language
Abstract
BackgroundSeveral European countries recently developed international diagnostic and management guidelines for pemphigus, which have been instrumental in the standardization of pemphigus management.ObjectiveWe now present results from a subsequent Delphi consensus to broaden the generalizability of the recommendations.MethodsA preliminary survey, based on the European Dermatology Forum and the European Academy of Dermatology and Venereology guidelines, was sent to a panel of international experts to determine the level of consensus. The results were discussed at the International Bullous Diseases Consensus Group in March 2016 during the annual American Academy of Dermatology conference. Following the meeting, a second survey was sent to more experts to achieve greater international consensus.ResultsThe 39 experts participated in the first round of the Delphi survey, and 54 experts from 21 countries completed the second round. The number of statements in the survey was reduced from 175 topics in Delphi I to 24 topics in Delphi II on the basis of Delphi results and meeting discussion.LimitationsEach recommendation represents the majority opinion and therefore may not reflect all possible treatment options available.ConclusionsWe present here the recommendations resulting from this Delphi process. This international consensus includes intravenous CD20 inhibitors as a first-line therapy option for moderate-to-severe pemphigus.