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Prof. Nurimar
Conceição Fernandes
Universidade
Federal do Rio de Janeiro, Email: nurimarfernandes@terra.com.br
*Corresponding author: Prof. Nurimar
Conceição Fernandes, Universidade Federal do Rio de Janeiro, Email: nurimarfernandes@terra.com.br
Citation: Prof. Nurimar Conceição Fernandes (2020) Treatment of Pemphigus Vulgaris and Pemphigus
Foliaceus: Experience with 30 Patients. Sci World J Skin Dis
Venereol, 1(1); 1-4
Copyright: © 2020, Prof.
Fernandes NC, et al., This is an open-access article distributed
under the terms of the Creative Commons Attribution 4.0 International License,
which permits unrestricted use, distribution and reproduction in any medium,
provided the original author and source are credited.
ABSTRACT
Pemphigus
vulgaris and Pemphigus foliaceus are chronic, painful
diseases which treatment causes great impact. This study focuses on the age,
gender, mucosal lesions, therapy with oral prednisone, clinical remission rates
and side effects. Material And Methods:
Six males/15 females with Pemphigus vulgaris
and three males/six females with non-endemic pemphigus foliaceus attended at
Hospital Universitario from 2003 to 2018 were submitted to histopathology
through skin or mucosa biopsy. Oral prednisone (monotherapy) in seven Pemphigus vulgaris and two pemphigus
foliaceus; in case of no control or relapses, association with cyclophosphamide
pulse therapy (12PV/4PF), dexamethasone pulse therapy (ten PV/two PF),
hydroxychloroquine (three PV/four PF), azathioprine (five PV),methotrexate
(four PV/one PF), immunoglobulin cycles (two PV/two PF). Results: Mostly patients were female aged 30-59 years old; oral
mucosal lesions in 19 (90,4%) pemphigus vulgaris. After a ten year period of
monitoring it was observed in the group of monotherapy: one PV/one PF achieved
complete remission on low dose of prednisone; two PV achieved partial remission
on low dose and four PV/one PF on high dose. In the group with combined drugs,
four PV were off prednisone, four PV/one PF achieved complete remission on low
dose and two PF on high dose; two PV/three PF achieved partial remission on low
dose and four PV/one PF on high dose. The most common side effects of
prednisone were mucocutaneous candidiasis, arterial hypertension, subcapsular
posterior cataracts, bacterial and viral infections and diabetes mellitus. Conclusion: Both diseases ran a chronic
and unpredictable course which management was extremely difficult. Females with
pemphigus vulgaris developed severe multiple mucosal lesions.
KEYWORDS: Pemphigus,
Prednisone, Pulse therapy, Clinical protocols, Immunosuppressive agents
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