INFLUENCE OF TREATMENT ON THE CLINICAL COURSE OF PEMPHIGUS-VULGARIS

Background: Pemphigus vulgaris (PV) is a potentially fatal autoimmune blistering disease. Objective: Our purpose was to summarize reported r esults of treatment for PV and suggest a basis for future studies. Met hods: This retrospective review applies objective criteria to 77 studi es published during the last half century. It includes only patients o lder than 18 years of age with idiopathic PV and excludes patients wit h drug-induced PV. Results: Systemic corticosteroids significantly (p = 0.001) reduced the mortality rate associated with PV compared with n o treatment in the presteroid era. Adjuvants used with steroids signif icantly (p = 0.001) reduced the mortality rate compared with the stero id era. The mortality rate of Jewish patients is significantly (p = 0. 001) higher than for non-Jewish patients. The outcome of PV is not inf luenced by the site of the initial lesion. Conclusion: Although the re trospective nature of this review limits its validity, we conclude pre dnisone with an adjuvant is the preferred treatment, and methotrexate should be avoided.