Trichoscopy as a Monitoring Tool for Activity and Remission in Pemphigus Vulgaris: A Clinical Study Supported by Immunological Evaluation.

NCT06863454 | Not Yet Recruiting

• 1 other identifier: Tricho PV
• Study Type: observational
• Target: 62
• Locations: 0 countries
• Sites: N/A

Brief Summary

Pemphigus vulgaris (PV) is a potential life-threatening autoimmune bullous disorder presenting with multiple erosions and flaccid blisters that can involve both mucous membrane and skin. The microscopic findings include intraepithelial blisters caused by acantholysis of keratinocytes as the consequence of autoantibody formation. The antibodies are mainly IgG autoantibodies mostly directed against desmoglein 1 and 3 (Dsg 1, 3), which are adhesion molecules expressed on the surface of keratinocytes.

Conditions

Pemphigus Vulgaris (PV)

Outcome Measures

Primary Outcomes (1)

• Trichoscopy as a monitooring tool

  for activity and remission in PV

  1 year

Study Arms (3)

Group 1

cases of PV with disease activity

Diagnostic Test: Trichoscopy

Group 2

cases of PV with disease remission

Diagnostic Test: Trichoscopy

Group 3

control group

Interventions

Trichoscopy DIAGNOSTIC_TEST

Trichoscopy will be done on patients with PV disease activity and remission

Group 1; Group 2

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients will be recruited from those attending the Bullous outpatient clinic of department of Dermatology, Assiut University Hospitals with the diagnosis of pemphigus vulgaris. Patients will be included in the study after obtaining a written informed consent. And after the approval of the faculty of medicine ethics committee. An age and sex matched healthy volunteers will be recruited as a control group.

You may qualify if:

• Patients with clinical and histopathological diagnosis of pemphigus vulgaris will be included.
• Pemphigus patients are categorized as active or remittent.

You may not qualify if:

• Other forms of pemphigus.
• Patients who are previously treated with rituximab.
• Patients with any concomitant dermatological diseases.
• Patients with other autoimmune diseases.
• Pregnancy and lactation.

Sponsors & Collaborators

• Assiut University: lead

Related Publications (29)

• Xu RC, Zhu HQ, Li WP, Zhao XQ, Yuan HJ, Zheng J, Pan M. The imbalance of Th17 and regulatory T cells in pemphigus patients. Eur J Dermatol. 2013 Nov-Dec;23(6):795-802. doi: 10.1684/ejd.2013.2177.

  PMID: 24192290 BACKGROUND

• Wu H, Stanley JR, Cotsarelis G. Desmoglein isotype expression in the hair follicle and its cysts correlates with type of keratinization and degree of differentiation. J Invest Dermatol. 2003 Jun;120(6):1052-7. doi: 10.1046/j.1523-1747.2003.12234.x.

  PMID: 12787134 BACKGROUND

• Veraitch O, Ohyama M, Yamagami J, Amagai M. Alopecia as a rare but distinct manifestation of pemphigus vulgaris. J Eur Acad Dermatol Venereol. 2013 Jan;27(1):86-91. doi: 10.1111/j.1468-3083.2011.04363.x. Epub 2011 Nov 28.

  PMID: 22122058 BACKGROUND

• Tavakolpour S, Mahmoudi H, Mirzazadeh A, Balighi K, Darabi-Monadi S, Hatami S, GhasemiAdl M, Daneshpazhooh M. Pathogenic and protective roles of cytokines in pemphigus: A systematic review. Cytokine. 2020 May;129:155026. doi: 10.1016/j.cyto.2020.155026. Epub 2020 Feb 10.

  PMID: 32058276 BACKGROUND

• Takahashi H, Amagai M, Nishikawa T, Fujii Y, Kawakami Y, Kuwana M. Novel system evaluating in vivo pathogenicity of desmoglein 3-reactive T cell clones using murine pemphigus vulgaris. J Immunol. 2008 Jul 15;181(2):1526-35. doi: 10.4049/jimmunol.181.2.1526.

  PMID: 18606708 BACKGROUND

• Sar-Pomian M, Rudnicka L, Olszewska M. The Significance of Scalp Involvement in Pemphigus: A Literature Review. Biomed Res Int. 2018 Mar 25;2018:6154397. doi: 10.1155/2018/6154397. eCollection 2018.

  PMID: 29770335 BACKGROUND

• Sar-Pomian M, Rudnicka L, Olszewska M. Trichoscopy - a useful tool in the preliminary differential diagnosis of autoimmune bullous diseases. Int J Dermatol. 2017 Oct;56(10):996-1002. doi: 10.1111/ijd.13725. Epub 2017 Aug 30.

  PMID: 28856676 BACKGROUND

• Sar-Pomian M, Kurzeja M, Rudnicka L, Olszewska M. The value of trichoscopy in the differential diagnosis of scalp lesions in pemphigus vulgaris and pemphigus foliaceus. An Bras Dermatol. 2014 Nov-Dec;89(6):1007-12. doi: 10.1590/abd1806-4841.20143830.

  PMID: 25387515 BACKGROUND

• Salmanpour R, Shahkar H, Namazi MR, Rahman-Shenas MR. Epidemiology of pemphigus in south-western Iran: a 10-year retrospective study (1991-2000). Int J Dermatol. 2006 Feb;45(2):103-5. doi: 10.1111/j.1365-4632.2004.02374.x.

  PMID: 16445496 BACKGROUND

• Saleh MA, Ishii K, Yamagami J, Shirakata Y, Hashimoto K, Amagai M. Pathogenic anti-desmoglein 3 mAbs cloned from a paraneoplastic pemphigus patient by phage display. J Invest Dermatol. 2012 Apr;132(4):1141-8. doi: 10.1038/jid.2011.449. Epub 2012 Jan 26.

  PMID: 22277944 BACKGROUND

• Rudnicka L, Olszewska M, Rakowska A, Slowinska M. Trichoscopy update 2011. J Dermatol Case Rep. 2011 Dec 12;5(4):82-8. doi: 10.3315/jdcr.2011.1083.

  PMID: 22408709 BACKGROUND

• Rudnicka L, Olszewska M, Rakowska A, Kowalska-Oledzka E, Slowinska M. Trichoscopy: a new method for diagnosing hair loss. J Drugs Dermatol. 2008 Jul;7(7):651-4.

  PMID: 18664157 BACKGROUND

• Rosenbach M, Murrell DF, Bystryn JC, Dulay S, Dick S, Fakharzadeh S, Hall R, Korman NJ, Lin J, Okawa J, Pandya AG, Payne AS, Rose M, Rubenstein D, Woodley D, Vittorio C, Werth BB, Williams EA, Taylor L, Troxel AB, Werth VP. Reliability and convergent validity of two outcome instruments for pemphigus. J Invest Dermatol. 2009 Oct;129(10):2404-10. doi: 10.1038/jid.2009.72. Epub 2009 Apr 9.

  PMID: 19357707 BACKGROUND

• Rahbar Z, Daneshpazhooh M, Mirshams-Shahshahani M, Esmaili N, Heidari K, Aghazadeh N, Hejazi P, Ghajarzadeh M, Chams-Davatchi C. Pemphigus disease activity measurements: pemphigus disease area index, autoimmune bullous skin disorder intensity score, and pemphigus vulgaris activity score. JAMA Dermatol. 2014 Mar;150(3):266-72. doi: 10.1001/jamadermatol.2013.8175.

  PMID: 24429657 BACKGROUND

• Pisanti S, Sharav Y, Kaufman E, Posner LN. Pemphigus vulgaris: incidence in Jews of different ethnic groups, according to age, sex, and initial lesion. Oral Surg Oral Med Oral Pathol. 1974 Sep;38(3):382-7. doi: 10.1016/0030-4220(74)90365-x. No abstract available.

  PMID: 4528670 BACKGROUND

• Pirmez R. Acantholytic hair casts: a dermoscopic sign of pemphigus vulgaris of the scalp. Int J Trichology. 2012 Jul;4(3):172-3. doi: 10.4103/0974-7753.100087.

  PMID: 23180929 BACKGROUND

• Murrell DF, Dick S, Ahmed AR, Amagai M, Barnadas MA, Borradori L, Bystryn JC, Cianchini G, Diaz L, Fivenson D, Hall R, Harman KE, Hashimoto T, Hertl M, Hunzelmann N, Iranzo P, Joly P, Jonkman MF, Kitajima Y, Korman NJ, Martin LK, Mimouni D, Pandya AG, Payne AS, Rubenstein D, Shimizu H, Sinha AA, Sirois D, Zillikens D, Werth VP. Consensus statement on definitions of disease, end points, and therapeutic response for pemphigus. J Am Acad Dermatol. 2008 Jun;58(6):1043-6. doi: 10.1016/j.jaad.2008.01.012. Epub 2008 Mar 14.

  PMID: 18339444 BACKGROUND

• Kasperkiewicz M, Ellebrecht CT, Takahashi H, Yamagami J, Zillikens D, Payne AS, Amagai M. Pemphigus. Nat Rev Dis Primers. 2017 May 11;3:17026. doi: 10.1038/nrdp.2017.26.

  PMID: 28492232 BACKGROUND

• Hennerici T, Pollmann R, Schmidt T, Seipelt M, Tackenberg B, Mobs C, Ghoreschi K, Hertl M, Eming R. Increased Frequency of T Follicular Helper Cells and Elevated Interleukin-27 Plasma Levels in Patients with Pemphigus. PLoS One. 2016 Feb 12;11(2):e0148919. doi: 10.1371/journal.pone.0148919. eCollection 2016.

  PMID: 26872212 BACKGROUND

• Hebert V, Boulard C, Houivet E, Duvert Lehembre S, Borradori L, Della Torre R, Feliciani C, Fania L, Zambruno G, Camaioni DB, Didona B, Marinovic B, Schmidt E, Schumacher N, Hunefeld C, Schanz S, Kern JS, Hofmann S, Bouyeure AC, Picard-Dahan C, Prost-Squarcioni C, Caux F, Alexandre M, Ingen-Housz-Oro S, Bagot M, Tancrede-Bohin E, Bouaziz JD, Franck N, Vabres P, Labeille B, Richard MA, Delaporte E, Dupuy A, D'Incan M, Quereux G, Skowro F, Paul C, Livideanu CB, Beylot-Barry M, Doutre MS, Avenel-Audran M, Bedane C, Bernard P, Machet L, Maillard H, Jullien D, Debarbieux S, Sassolas B, Misery L, Abasq C, Dereure O, Lagoutte P, Ferranti V, Werth VP, Murrell DF, Hertl M, Benichou J, Joly P; French Study Group on Autoimmune Bullous Skin Diseases; Autoimmune Bullous Skin Disease Task Force of the European Academy of Dermatology and Venereology. Large International Validation of ABSIS and PDAI Pemphigus Severity Scores. J Invest Dermatol. 2019 Jan;139(1):31-37. doi: 10.1016/j.jid.2018.04.042. Epub 2018 Oct 6.

  PMID: 30301637 BACKGROUND

• Hammers CM, Stanley JR. Mechanisms of Disease: Pemphigus and Bullous Pemphigoid. Annu Rev Pathol. 2016 May 23;11:175-97. doi: 10.1146/annurev-pathol-012615-044313. Epub 2016 Feb 22.

  PMID: 26907530 BACKGROUND

• Fang H, Li Q, Wang G. The role of T cells in pemphigus vulgaris and bullous pemphigoid. Autoimmun Rev. 2020 Nov;19(11):102661. doi: 10.1016/j.autrev.2020.102661. Epub 2020 Sep 14.

  PMID: 32942041 BACKGROUND

• Esmaili N, Chams-Davatchi C, Valikhani M, Daneshpazhooh M, Balighi K, Hallaji Z, Barzegari M, Akhyani M, Ghodsi ZS, Mrotazavi H, Naraghi ZS, Toosi S. Pemphigus vulgaris in Iran: a clinical study of 140 cases. Int J Dermatol. 2007 Nov;46(11):1166-70. doi: 10.1111/j.1365-4632.2007.03334.x.

  PMID: 17988336 BACKGROUND

• David M, Katzenelson V, Hazaz B, Ben-Chetrit A, Sandbank M. Determination of IgG subclasses in patients with pemphigus with active disease and in remission. Arch Dermatol. 1989 Jun;125(6):787-90.

  PMID: 2658844 BACKGROUND

• Daneshpazhooh M, Naraghi ZS, Ramezani A, Ghanadan A, Esmaili N, Chams-Davatchi C. Direct immunofluorescence of plucked hair for evaluation of immunologic remission in pemphigus vulgaris. J Am Acad Dermatol. 2011 Dec;65(6):e173-7. doi: 10.1016/j.jaad.2010.09.721. Epub 2011 Jun 22.

  PMID: 21696851 BACKGROUND

• Berrih-Aknin S, Le Panse R. Myasthenia gravis: a comprehensive review of immune dysregulation and etiological mechanisms. J Autoimmun. 2014 Aug;52:90-100. doi: 10.1016/j.jaut.2013.12.011. Epub 2014 Jan 3.

  PMID: 24389034 BACKGROUND

• Asothai R, Anand V, Das D, Antil PS, Khandpur S, Sharma VK, Sharma A. Distinctive Treg associated CCR4-CCL22 expression profile with altered frequency of Th17/Treg cell in the immunopathogenesis of Pemphigus Vulgaris. Immunobiology. 2015 Oct;220(10):1129-35. doi: 10.1016/j.imbio.2015.06.008. Epub 2015 Jun 17.

  PMID: 26093920 BACKGROUND

• Arya SR, Valand AG, Krishna K. A clinico-pathological study of 70 cases of pemphigus. Indian J Dermatol Venereol Leprol. 1999 Jul-Aug;65(4):168-71.

  PMID: 20921646 BACKGROUND

• Araghi F, Dadkhahfar S, Robati RM, Tabary M, Shahidi-Dadras M. The emerging role of T cells in pemphigus vulgaris: a systematic review. Clin Exp Med. 2023 Aug;23(4):1045-1054. doi: 10.1007/s10238-022-00855-8. Epub 2022 Aug 4.

  PMID: 35925475 BACKGROUND

MeSH Terms

Conditions

Pemphigus

Condition Hierarchy (Ancestors)

Skin Diseases, Vesiculobullous; Skin Diseases; Skin and Connective Tissue Diseases; Autoimmune Diseases; Immune System Diseases

Central Study Contacts

Sara Mohamed Ibrahim Awad, Professor

CONTACT

+201023102094; saramawad@gmail.com

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle investigator

Study Record Dates

• First Submitted: March 3, 2025
• First Posted: March 7, 2025
• Study Start: May 1, 2025
• Primary Completion: May 1, 2026
• Study Completion: May 1, 2026
• Last Updated: March 7, 2025

Record last verified: 2025-02