Presentation
In this study of skin biopsy specimens from 14 patients we present evidence that complement and immunoglobulins were present by direct immunofluorescence in the epidermal intercellular spaces in all patients. [ncbi.nlm.nih.gov]
Entire Body System
- Constitutional Symptom
Secondary bacterial infection is common which may lead to constitutional symptoms, malodorous smell of the mucous membrane, and skin lesions. Differential Diagnosis of Pemphigus ‘Pemphigus syphiliticus‘: occurs in some babies. [drmhijazy.com]
- Chills
Fever, malaise, headache, muscle pain, chills, anorexia, and weight loss occur. The intensity of the symptoms is directly proportional to the spread of the lesions. [kundoc.com]
- Fever
Fever, malaise, headache, muscle pain, chills, anorexia, and weight loss occur. The intensity of the symptoms is directly proportional to the spread of the lesions. [kundoc.com]
- Anorexia
Fever, malaise, headache, muscle pain, chills, anorexia, and weight loss occur. The intensity of the symptoms is directly proportional to the spread of the lesions. [kundoc.com]
Skin
- Blister
(Simuliidae), suggesting an environmental link Management Steroids fogo selvagem (fo'go, goo sel-va'zhem) [Portuguese, literally “wild fire”], FS An autoimmune disease that causes blistering of the skin of the head, neck or trunk, esp. when the skin [medical-dictionary.thefreedictionary.com]
Pathol. any of several diseases, often fatal, characterized by blisters on the skin and mucous membranes. [1770 80; < NL < Gk pemphig (s. of pémphix) bubble + L us n.… … Universalium [translate.deacademic.com]
Abstract Brazilian pemphigus foliaceus is a blistering skin disease endemic to central and southern areas of South America. [ncbi.nlm.nih.gov]
- Skin Disease
Abstract Brazilian pemphigus foliaceus is a blistering skin disease endemic to central and southern areas of South America. [ncbi.nlm.nih.gov]
• Brazilian pemphigus foliaceus is a blistering skin disease endemic to central and southern areas of South America. [jamanetwork.com]
Abstract Pemphigus foliaceus (PF) is a blistering autoimmune skin disease rare in most of the world but endemic in certain regions of Brazil. [medworm.com]
Brazilian pemphigus foliaceus is a blistering skin disease endemic to central and southern areas of South America. [pubfacts.com]
- Nikolsky's Sign
They will look for an indicator of the condition called Nikolsky’s sign. A positive Nikolsky’s sign is when your skin shears off easily when the surface is wiped sideways with a cotton swab or a finger. [healthline.com]
The mucosal membranes were respected (fig 1 ), and Nikolsky’s sign was positive. Histological studies of a lesion showed splitting of the upper epidermis. [adc.bmj.com]
- Insect Bite
Thus, insect bites may deliver salivary Ags that initiate a cross-reactive IgG4 Ab response in genetically susceptible individuals and lead to subsequent FS. [ncbi.nlm.nih.gov]
Thus, insect bites may deliver salivary Ags that initiate a cross-reactive... More Keywords Article Link > Most Popular Services [genscript.com]
The precise etiology is unknown, but immunogenetic, immunologic, and environmental factors contribute to its pathogenesis. [5] It may be due to a pathogenic IgG4 response triggered by hematophagous insect bites. [6] A 15-year surveillance of the Limao [emedicine.medscape.com]
- Plantar Hyperkeratosis
The scalp is thickly crusted and palmo-plantar hyperkeratosis occurs. Hyperpigmented macules develop after some years and are a favorable prognostic sign,’ heralding the next stage. [kundoc.com]
Neurologic
- Dysesthesia
It often causes a burning dysesthesia, from which its popular name is derived. The disease is typically found in Brazil or Colombia and has been associated with chronic or recurrent exposure to black flies. Synonym: endemic pemphigus foliaceus. [medical-dictionary.thefreedictionary.com]
- Meningism
They were classified as pulmonary (tuberculosis, pneumonia and bronchial pneumonia), cardiac (endocarditis, pericarditis), hepatic (fulminant hepatitis, cirrhosis), renal (diffuse acute glomerulonephritis, subacute glomerulonephritis), nervous(meningitis [kundoc.com]
Workup
Microbiology
- Complement Fixing Antibody
Complement fixing antibodies were found in four patients. However, the distribution of IgG subclasses was incompatible with their known characteristics in terms of complement activation. [ncbi.nlm.nih.gov]
- Trypanosoma Cruzi
Di Zenzo G, Zambruno G, Borradori L Profile of Trypanosoma cruzi reactivity in a population at high risk for endemic pemphigus foliaceus (Fogo selvagem). [medicbind.com]
HLA Type
- HLA-DR4
Human leucocyte antigens class II (HLA-DR4) alleles were linked to the disease in Ashkenazi Jews and other populations(2). [rug.nl]
DNA typing for class I 1 HLA antigens with allele-specific or groupspecific amplification. 1. Typing for subsets of HLA- DR4. Hum Immunol 1990: 27: 40-50. Fernandez-Viiia, M. Shumway W. Stastny P. [docslide.com.br]
Pemphigus is more common in persons with certain HLA allotypes. HLA DR4 and DR14 (DRB1*0402 and DRB1*0401 more specifically) crucial in susceptibility. [pemphigus.org]
- HLA-DR1
The HLA-DR1-Dw20 (DRB1*0102) gene is related to susceptibility to fogo selvagem, whereas absence of the HLA-DQw2 (DQB1*0201) allele is linked with resistance. Not surprising, familial cases have been described. [emedicine.medscape.com]
DNA typing for class I1 HLA antigens with allele-specific or groupspecific amplification. V. Typing for subsets of HLA-DR1 and DR'Br'. Hum Immunol 1991: 31: 147-54. Petzl-Erler ML, Santamaria J. [docslide.com.br]
- HLA-DR2
DNA typing for class I1 HLA antigens with allele-specific or group specific amplification. IV. Typing for alleles of the HLA- DR2 group. Hum Immwol 1991: 31: 139-44. Gao X, Moraes R, Miller S, Stastny P. [docslide.com.br]
Treatment
Autoantibodies deposited in the intercellular spaces in titers ranging from 1:10 to more than 1:1280, and the titers drastically decreased during treatment. [ncbi.nlm.nih.gov]
الصفحة 7 - A et al: A comparison of the efficacy and safety of adapalene gel 0.1% and tretinoin gel 0.025% in the treatment of acne vulgaris: A multicenter trial. [books.google.com]
(no treatment, treated, and post-treatment). [journal.frontiersin.org]
Biologics: This is a newer treatment option. One biologic, rituximab, seems promising. It appears to offer safe treatment. [aad.org]
Treatment of BP is summarized in Box 2. Box 2. [clevelandclinicmeded.com]
Prognosis
In general, PF and PE have a better prognosis than pemphigus vulgaris. However, prior to the advent of glucocorticoid therapy, the mortality rate was as high as 60%. [dermnet.com]
[…] malignancy, and our present observation draws ... more Abstract Fogo Selvagem (Wildfire) is a cutaneous disease characterized by a specific epidemiology, generalized distribution of bullae followed by an exfoliative erythroderma, and frequently, a grave prognosis [scinapse.io]
With adequate treatment, the prognosis of fogo selvagem is good with no long-term sequelae. See smartphone apps to check your skin. [Sponsored content] Related information References Abréu-Vélez A, Reason M, Howard S & Roselino A. [dermnetnz.org]
Key words: pemphigus; vulgaris; foliaceus; epidemiology; mortality; prognosis. Accepted May 22, 2017; Epub ahead of print May 24, 2017 Acta Derm Venereol 2017; 97: xx–xx. [medicaljournals.se]
The prognosis of pemphigus foliaceus is markedly better than that of pemphigus vulgaris, probably because of the more superficial nature of the blistering process, and treatment should be chosen with this in mind, especially in children. [adc.bmj.com]
Etiology
The possible relationship of an elevated level of IgE with respect to other aberrations of immunologic responsiveness and the suggested infectious etiology of BPF are considered. [ncbi.nlm.nih.gov]
Inflammatory cytokines and apoptosis are also involved. [16] Its etiology is unknown, but blister formation appears to be mainly IgG4 mediated. [emedicine.medscape.com]
Additionally, we are investigating the etiology of Brazilian PF (Fogo Selvagem) as a joint project with Brazilian investigators. The research projects of this laboratory are supported by NIH. [med.unc.edu]
Shoenfeld received the EULAR prize in 2005, in Vienna, Austria: "The infectious etiology of anti-phospholipid syndrome". [books.google.ro]
Epidemiology
Epidemiologic data strongly support the notion that this disease is caused by exposure to an environmental agent or agents. [ncbi.nlm.nih.gov]
[Pg. wild fire] A form of pemphigus foliaceus, an autoimmune blistering disorder, which is endemic in rural Colombia and Brazil Epidemiology Fogo selvagem affects children and young adults and is distributed along rivers within the flying range of blackflies [medical-dictionary.thefreedictionary.com]
The disease follows the course of streams and creeks and vanishes after urbanization of the endemic areas. [11] Epidemiologic findings indicate that peasants exposed to black fly bites are 4.7 times more likely to develop fogo selvagem than those who [emedicine.medscape.com]
Pathophysiology
Patient case no. 10989 Date added 03 June 2011 Patient details Age Adult Location Brazil Localisation Trunk / entire trunk Description Pemghigus foliaceus in a patient from Brazil, where fogo selvagem is prevalent Primary Lesions Bulla / blister Crust Pathophysiology [dermquest.com]
However, because the desmoglein ELISA measures both pathogenic as well as nonpathogenic antibodies (see “Pathophysiology” below), positive desmoglein ELISA index values may still be observed in patients in remission. [dermatologyadvisor.com]
[…] death occurring in PF.65,76 Infection is often the cause of death, and therapy is frequently a contributing factor because it causes the immunosuppression necessary to treat active disease.77 The effective management of PF requires a knowledge of the pathophysiology [mdedge.com]
The pivotal contributions of Jean-Claude Bystryn have been summarized. [9] Pathophysiology Superficial blisters in pemphigus foliaceus are induced by immunoglobulin G (IgG) (mainly IgG4 subclass) autoantibodies directed against a cell adhesion molecule [emedicine.medscape.com]
Prevention
Treatment is aimed at reducing pain and symptoms and preventing complications like infection. It involves one or more drugs and other methods. [healthline.com]
Consequently, elevations of circulating plasma FFA concentration can be prevented if large amounts of insulin can be secreted. [scienceopen.com]
IVIG is normally given with other therapy, such as steroids and immunosuppressives, to prevent rebound of disease as the therapy is tapered. [rarediseases.org]
Switching to another medicine can also help prevent possible side effects that can occur when someone takes a corticosteroid for a long time. [aad.org]
The adaptive immune system, also known as the acquired immune system or, more rarely, as the specific immune system, is composed of highly specialized, systemic cells and processes that eliminate or prevent pathogen growth. [theuniversalmatrix.com]