case_images: PMC11231183_01
case_images: Oral and laryngeal erosions after apremilast discontinuation.
case_images: fimmu-15-1404185-g001.jpg
case_images: PMC11231183_01_fimmu-15-1404185-g001.jpg
case_images: f1
case_images: This discontinuation led to a rapid relapse after a few days with new painful oral lesions, pharyngeal and laryngeal erosions ( Figure 1 ), choanal crusts and non-fibrosing conjunctivitis despite the prednisolone mouthwashes (prednisolone 20 mg soluble tablets, twice a day).
case_images: Evolution over time of anti-Dsg3 autoantibodies titer, weight, numeric pain rating scale and number of oral lesions.
case_images: fimmu-15-1404185-g002.jpg
case_images: PMC11231183_01_fimmu-15-1404185-g002.jpg
case_images: f2
case_images: Awaiting laboratory investigation results and considering its previous efficacy and its favorable safety profile, apremilast was resumed off-label at 30 mg twice daily, resulting again in significant improvement of the pain with a quick cessation of new oral lesions within a few days ( Figure 2 ). Anti-Dsg3 ELISA was retrospectively performed on former sera showing a gradual decrease of its levels, beginning while she received apremilast alone ( Figure 2 ).