skin disorders
Pemphigus Vulgaris
Treatment of Pemphigus Vulgaris
Corticosteroids (oral or intravenous) Antibiotics and protective dressings for ruptured blisters Often immunosuppressants or immune globulin to reduce corticosteroid use People who have moderate to severe disease are hospitalized. In the hospital, the raw skin surfaces require extraordinary care, similar to the care given to people with severe burns. Antibiotics may be needed to treat infections in ruptured blisters. Dressings can protect raw, oozing areas. High doses of corticosteroids are the mainstay of treatment. They are taken by mouth (orally) or, if the person is hospitalized, may be given by vein (intravenously). If the disease is controlled, the dose of corticosteroids is gradually reduced (tapered). Sometimesrituximab, a drug that suppresses the immune system (immunosuppressant), is given with corticosteroids. If the person does not respond to treatment or the disease flares up as the dose is tapered, an immunosuppressant, such asazathioprine,cyclophosphamide,methotrexate,mycophenolatemofetil,cyclosporine, orrituximab(if not already given), is also given. Immunosuppressants may also be given to reduce the need for corticosteroids in people who have needed corticosteroids for a long time or at high doses. Immune globulin given by vein is another treatment that can be used for severe pemphigus vulgaris. Some people respond well enough to discontinue drug therapy, whereas others must continue taking low doses of the drugs for long periods. People with severe pemphigus vulgaris may also undergo Plasma exchange , a process in which antibodies are filtered from the blood. 