Treatment of pemphigus vulgaris with brief, high-dose intravenous glucocorticoids

Role of Corticosteroids in Oral Lesions

“…Some received only one course of pulse therapy, while others received two courses. This study showed the superiority of pulse therapy over conventional treatment (Werth 1996).…”

Pemphigus Vulgaris IgG and Methylprednisolone Exhibit Reciprocal Effects on Keratinocytes

“…The authors concluded that the major therapeutic effect of CH was due to reduction of antibody synthesis rather than modification of the events that occur within the epidermis after antibody binding. In turn, the adequacy of the conclusion drawn from the in vivo experiment has been challenged by the well established clinical fact that pulse therapy with a high dose of an intravenous administered glucocorticosteroid agent, such as MP, can stop acantholysis in PV patients within 24 -48 h, which is too early to induce changes in the serum titer of pemphigus autoantibodies (22,25,26). Therefore, we hypothesized that the discrepancy among the results of in vitro and in vivo experiments reported previously might be due to limitations of the mouse model used by Anhalt et al (3,84), and we sought to develop an adequate model for in vivo testing the anti-acantholytic efficacy of CH in pemphigus.…”

“…First, although the major decline in antibody titers occurs 3-4 weeks after glucocorticosteroid administration (19 -21), clinical lesions in PV patients usually improve much more rapidly, within 24 -48 h after initiation of a high dose, "pulse" therapy with methylprednisolone (MP) or dexamethasone, when the titer of pemphigus autoantibodies remains unchanged (22)(23)(24)(25)(26).…”

Pulsed High-Dose Corticosteroids Combined With Low-Dose Methotrexate in Severe Localized Scleroderma

“…[17][18][19] Administering pulsed highdose corticosteroids fully exhibits anti-inflammatory and immunomodulatory effects without occurrence of wellknown adverse effects associated with long-term corticosteroid treatment. 17 To combine the early antiinflammatory effects of corticosteroids and the antifibrotic action of methotrexate, Uziel et al 20 initiated a combined methotrexate (0.3-0.6 mg/kg weekly) and pulsed intravenous high-dose methylprednisolone (3 consecutive days monthly for 3 months) therapy in 10 children with LS.…”