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Kikuo Sakamoto, MD; Kazunori Mori, MD; Takashi Hashimoto, MD; Kim B. Yancey, MD; Tadashi Nakashima, MD

Arch Otolaryngol Head Neck Surg. 2002;128:1420-1423.

A case of antiepiligrin cicatricial pemphigoid that primarily involved the larynx and required a tracheostomy was studied. The diagnosis was based on the direct immunofluorescence findings of a biopsy specimen from the glottis, immunofluorescence using normal and 1M sodium chloride–split normal human skin as substrates, and immunoprecipitation. A dramatic clinical improvement was observed after the combined administration of tetracycline hydrochloride and niacinamide. The tracheal stoma could be shut after the narrow segment was cut by means of carbon dioxide laser therapy. The patient showed no respiratory difficulty during the 2-year follow-up period. The combined therapy of tetracycline and niacinamide is thus considered to be an effective treatment for various types of cicatricial pemphigoid.

From the Departments of Otolaryngology (Drs Sakamoto and Nakashima) and Dermatology (Dr Hashimoto), Kurume University School of Medicine, Kurume, Japan; Department of Otolaryngology–Head and Neck Surgery, Kinki University School of Medicine, Sayama, Japan (Dr Mori); and Dermatology Branch, Medical College of Wisconsin, Milwaukee (Dr Yancey).