Adjuvant Therapy of Pemphigus

“…Many patients are treated with daily steroid doses of 40 -80 mg 8,12 . A lack of prospective studies and of well controlled trials contribute to the dilemma over the best initial dose and maintenance theraphy 1,3 .…”

Section: Discussionmentioning

confidence: 99%

“…The terms activity, extent and severity are poorly defined; as a consequence, the evaluation of therapeutic results in published studies must be limited to an analysis of two basic variables: mortality and remission. The methodology used to define and study adverse effects is so wide and poorly described in most studies that no attempt have been made to analyze it 1,4,6 .…”

Section: Introductionmentioning

confidence: 99%

Treatment of pemphigus vulgaris and pemphigus foliaceus: experience with 71 patients over a 20 year period

Fernandes

Perez

2001

Rev. Inst. Med. trop. S. Paulo

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SUMMARYForty one cases of pemphigus vulgaris and thirty cases of pemphigus foliaceus were investigated at Hospital Universitário Clementino Fraga Filho from 1978 to 1999. They were divided into two treatment groups: one group received up to 100 mg of oral prednisone daily and the other group received >120 mg daily. The dose up to 100 mg provided good initial control of pemphigus vulgaris and pemphigus foliaceus and did not increase the mortality rate associated to disease. The dose >120 mg induced higher morbidity. These data allowed us to establish a regimen of oral prednisone (1-2 mg/kg/daily) with maximum of 120 mg daily in the treatment of pemphigus vulgaris and pemphigus foliaceus.

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“…The idea is to bring the patient into remission of their disease with steroids, using the smallest dosage possible; the reason for the smallest possible dosages is to avoid the possible comorbidities, such as Cushing's disease, osteoporosis, hypertension, and diabetes to name a few (Schacke 2002). As the patient begins to take systemic glucocorticoids, they can also be prescribed an adjunct treatment protocol with nonsteroidal but immunosuppressant drugs such as azathioprine and mycophenolate (Bystryn 1996). These are the same drugs used in many chemotherapy regimens for different cancers and other autoimmune conditions.…”

Section: Managementmentioning

confidence: 99%

A brief review of pemphigus vulgaris

Sanders

2017

biomed dermatol

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Pemphigus vulgaris is an autoimmune disorder which presents with painful mucocutaneous blisters and erosions. On the skin, they are flaccid bullae or erosions, and on the mucosa, they present as erosions. This disease is rare but is devastating to those who have it; it also is related-perhaps genetically-to other autoimmune conditions. This is to say that a patient can develop pemphigus vulgaris if they have thyroiditis or diabetes mellitus. Biopsy is needed to obtain histopathological evidence of the breakdown of intercellular connections due to the autoimmune attack on components of desmosomes, which are responsible for intercellular integrity above the basement membrane. When these desmosomes are attacked, loss of connection ensues, and the cells break apart at these connections; this leads to fluid buildup, seen grossly as bullae. Treatment of the disease is difficult and sometimes unsafe. For decades, the mainstay of treatment has been glucocorticoids followed by other drugs. Unfortunately, these drugs are systemically absorbed, and the side effect profile can be unfavorable. In the past several years however, more innovative treatments have emerged that may help ease the cost and safety burden to patients. This review highlights the major points about pemphigus vulgaris, its pathophysiology, and its treatment.

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Adjuvant Therapy of Pemphigus

Cited by 183 publications

References 56 publications

Role of Corticosteroids in Oral Lesions

Role of Corticosteroids in Oral Lesions

Treatment of pemphigus vulgaris and pemphigus foliaceus: experience with 71 patients over a 20 year period

A brief review of pemphigus vulgaris

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