Pemphigus vulgaris with oral involvement: evaluation of two different systemic corticosteroid therapeutic protocols

• Published in: Journal of the European Academy of Dermatology and Venereology Vol. 16; no. 4; pp. 353 - 356
• Main Authors: Femiano, F, Gombos, F, Scully, C
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.07.2002
• Subjects: Administration, Oral; Adult; Betamethasone - administration & dosage; Biopsy, Needle; corticosteroids; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Infusions, Intravenous; Linear Models; Male; Middle Aged; Mouth Mucosa - pathology; pemphigus; Pemphigus - drug therapy; Pemphigus - mortality; Pemphigus - pathology; Prednisone - administration & dosage; Probability; Prospective Studies; Severity of Illness Index; Survival Rate; Treatment Outcome; vesiculobullous disease
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1046/j.1468-3083.2002.00461.x

Background Pemphigus vulgaris is a potentially life‐threatening disease characterized by cutaneous and mucosal blistering. Systemic corticosteroids remain the mainstay of therapy, transforming an invariably fatal disease into one with a mortality that is now less than 10%. Nevertheless, oral lesions are often recalcitrant and corticosteroid therapy can provoke adverse effects. Objective To determine whether two different regimens of systemic corticosteroid therapy based on prednisone gave different benefits. Method We examined two different regimens of systemic corticosteroid therapy based on prednisone in an open study. Ten patients (group A) were treated with systemic corticosteroids, in a therapeutic protocol made up of orally administered prednisone. Ten matched patients (group B) were treated with systemic corticosteroids alternating a pulse of intravenous betamethasone with orally administered prednisone. Results and conclusions The pulse protocol appeared to have some advantages both in a shorter time to resolution of symptoms and oral lesions, and in terms of minor adverse effects.