De Dipankar, Mehta Hitaishi, Shah Shikha, Ajithkumar Kidangazhiathmana, Barua Shyamanta, Chandrashekar Laxmisha, Chatterjee Manas, Gupta Vishal, Khandpur Sujay, Khullar Geeti, Kolalapudi Seetharam Anjaneyulu, Kumar Sheetanshu, Neema Shekhar, Pandhi Deepika, Poojary Shital, Rai Reena, Rajagopalan Murlidhar, Rao Raghavendra, Shah Bela, Singal Archana, Thakur Vishal, Vinay Keshavamurthy, Aggrawal Ashutosh, De Arka, Mukherjee Soham, Prinja Shankar, Mahajan Rahul, Handa Sanjeev
Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Dermatology and Venereology, Govenment Medical College, Kottayam, Kerala, India.
Indian Dermatol Online J. 2024 Dec 26;16(1):3-24. doi: 10.4103/idoj.idoj_1059_24. eCollection 2025 Jan-Feb.
Pemphigus is an autoimmune blistering disorder characterized by the presence of intraepidermal blisters and erosions, primarily affecting the mucosa and/or skin. There are no established Indian guidelines for the management of pemphigus, and Western guidelines cannot be directly applied due to differences in clinicodemographic profiles, comorbidities, and resource limitations. These guidelines aim to provide Indian dermatologists with evidence-based and consensus-driven recommendations for the management of pemphigus vulgaris (PV) and pemphigus foliaceous (PF), taking into account the unique challenges posed by the Indian healthcare setting. The guidelines focus on the comprehensive management of PV and PF, addressing diagnosis, treatment, monitoring, and follow-up. It is intended for dermatologists working in both outpatient and inpatient settings across India. The first draft of the guidelines was prepared by the writing group and then reviewed by 19 national experts in pemphigus management, including inputs from allied specialties. Areas with limited evidence or anticipated variation in recommendations were subjected to rounds of voting, with responses categorized as "strongly agree," "agree," "neutral," "disagree," or "strongly disagree." Suggestions were incorporated, and statements were revised until a mean agreement score of 4 or higher was reached across 16 key areas after four voting rounds. These guidelines offer a structured approach to managing pemphigus in India, addressing the need for region-specific recommendations that account for unique challenges such as resource constraints and specific comorbidities in Indian patients. They serve as a valuable resource for dermatologists treating pemphigus in a range of clinical settings.
天疱疮是一种自身免疫性水疱性疾病，其特征为表皮内水疱和糜烂，主要累及黏膜和/或皮肤。目前尚无印度制定的天疱疮管理指南，由于临床人口统计学特征、合并症和资源限制方面存在差异，西方指南无法直接应用。这些指南旨在为印度皮肤科医生提供基于证据且经共识驱动的寻常型天疱疮（PV）和落叶型天疱疮（PF）管理建议，同时考虑到印度医疗环境带来的独特挑战。该指南侧重于PV和PF的综合管理，涵盖诊断、治疗、监测和随访。其目标受众为在印度门诊和住院环境工作的皮肤科医生。指南初稿由编写组制定，随后由19位天疱疮管理领域的国内专家进行评审，其中包括来自相关专业的意见。对于证据有限或建议预期存在差异的领域进行了多轮投票，回应分为“强烈同意”“同意”“中立”“不同意”或“强烈不同意”。建议被纳入其中，声明也经过修订，直到四轮投票后在16个关键领域的平均同意得分达到4分或更高。这些指南为印度天疱疮的管理提供了一种结构化方法，满足了针对特定区域建议的需求，这些建议考虑到了印度患者面临的独特挑战，如资源限制和特定合并症。它们是在一系列临床环境中治疗天疱疮的皮肤科医生的宝贵资源。
