Treatment of oral pemphigus vulgaris.
BACKGROUND
Oral pemphigus is considered to represent either an initial stage of pemphigus vulgaris that should be treated with high doses of immunosuppressive drugs to prevent its spread to the skin or a variety of the disease that does not need aggressive treatment. The absence of a widely accepted therapeutic method and the obscure nature of this disease prompted this study.


METHODS
Twenty-eight patients with oral pemphigus were randomly divided into three groups. The first group received only steroids at a dose of 40 mg of prednisone equivalent. In the other two groups the same dose of steroids was administered, but combined with either 100 mg of cyclophosphamide or 5 mg/kg of cyclosporine as an adjuvant. Direct immunofluorescence studies were performed on specimens obtained from both buccal mucosa and oral skin.


RESULTS
There was no significant difference in the duration of treatment required to achieve remission and in the relapse rate among the three groups. The incidence of complications was higher with combination treatment. Deposited immunoreactants were detected with equal frequency in specimens obtained from the buccal mucosa and normal skin.


CONCLUSIONS
Oral pemphigus most likely represents an initial stage of a disease that can become generalized. Administration of moderate doses of steroids alone is effective in controlling the disease.
Chrysomallis
F
F
Department of Dermatology, University of Thessaloniki Medical School, Greece.
Ioannides
D
D
Teknetzis
A
A
Panagiotidou
D
D
Minas
A
A
D000328:Adult; D000368:Aged; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005455:Fluorescent Antibody Technique; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D009061:Mouth Mucosa / Q000473:pathology; D010392:Pemphigus / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D012867:Skin / Q000473:pathology
D004338:Drug Combinations; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D016572:Cyclosporine; D003520:Cyclophosphamide; D011241:Prednisone