title: Pemphigus vulgaris: approach to treatment.
abstract: The therapeutic management of pemphigus vulgaris (PV) is centered around immunosuppression, which can be generalized, as in the use of corticosteroids or steroid sparing agents, or specific, as in therapeutic blockage of autoantibody production, certain cytokines, or signaling pathways. Currently, the backbone of treatment for PV, particularly, first line therapy, remains systemic corticosteroids. Although very effective, the significant side effects of long-term corticosteroid usage are well documented. Adjunctive therapies aim to eliminate, or at least decrease, the necessary dose of corticosteroids. Specifically, azathioprine, cyclophosphamide, methotrexate, cyclosporine, mycophenolate mofetil and dapsone are now widely used in PV. Intravenous immunoglobulin (IVIG), plasmapheresis, immunoadsorption, and most recently, rituximab, are other members of the therapeutic armamentarium. However, despite the widening range of treatment options in PV, well-controlled clinical trials and consensus guidelines are lacking.
authors.affiliation: Department of Dermatology, University of Buffalo 6078 Clinical and Translational Research Center 875 Ellicott Street, Buffalo, NY 14203.
authors.forename: Animesh A
authors.initials: AA
authors.lastname: Sinha
authors.affiliation: Department of Dermatology, University of Buffalo 6078 Clinical and Translational Research Center 875 Ellicott Street, Buffalo, NY 14203.
authors.forename: Melissa B
authors.initials: MB
authors.lastname: Hoffman
authors.affiliation: Department of Dermatology, University of Buffalo 6078 Clinical and Translational Research Center 875 Ellicott Street, Buffalo, NY 14203.
authors.forename: Elise C
authors.initials: EC
authors.lastname: Janicke
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000818:Animals; D001402:B-Lymphocytes; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007167:Immunotherapy; D008212:Lymphocyte Depletion; D010392:Pemphigus / Q000628:therapy*; D010956:Plasmapheresis; D000069283:Rituximab / Q000627:therapeutic use*; D015398:Signal Transduction / Q000187:drug effects; D013601:T-Lymphocytes; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab
keywords: immunosuppressive; immunotherapy; pemphigus vulgaris; rituximab; treatment