What is the role of intravenous immunoglobulin (IVIG) in the treatment of skin disease?

Updated: Jul 05, 2018
  • Author: Jessica Katz, MD, PhD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Because most skin disease has an immunological effect, the fact that IVIG is helpful for treating these conditions is not surprising. It has been reported useful in the treatment of autoimmune blistering diseases, lupus erythematosus, dermatomyositis, scleroderma, toxic epidermal necrolysis, atopic dermatitis, pyoderma gangrenosum, epidermolysis bullosa acquisita, herpes gestationis, erythema multiforme, and chronic autoimmune urticaria. Other uses include treatment for pemphigus foliaceus, mucous membrane pemphigoid, and mixed connective-tissue disease.

IVIG has both agonistic and blocking antibodies against Fas (CD95), the receptor for the Fas ligand, which triggers apoptotic signals into cells. This is likely what underlies its efficacy for treating toxic epidermal necrolysis.

In persons with dermatomyositis, IVIG decreases plasma levels of membrane attack complex and substantially decreases the amounts of C3b and membrane attack complex deposited in endomysial capillaries.


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