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[A clinical analysis of 64 cases of pemphigus]
Objective:
Reasonable therapeutic dosage regimen for pemphigus are analyzed to find the factors related to prognosis.
Methods:
A retrospective study is made on 64 cases of pemphigus who were admitted to our hospital between 1986-1996.
Results:
Sixty-two of 64 cases with pemphigus were treated with systemic administration of corticosteroids. The average dosage of prednisone for controlling the diseases were 0.958 mg.kg-1.d-1 for mild-type of pemphigus (12 cases) and 1.145 mg.kg-1.d-1 for severe-type (50 cases) respectively. Furthermore, 26 of 62 cases were treated with corticosteroids only, and the average dosage of prednisone for controlling the diseases was 1.072 mg.kg-1.d-1 while in 36 cases treated with corticosteroids combined with immunosuppressors, the average dosage of prednisone was 1.178 mg.kg-1.d-1. The rate of side-effects and complications were 15.4% in patients with corticosteroids alone and 36.1% in patients with combined therapy. Six of eight patients who died were diagnosed pemphigus vulgaris and seven with a course of disease less than 3 years.
Conclusions:
We recommend a moderate to high dosage of corticosteroids be the first choice to control pemphigus. Those who were effective with steroids are not recommended to use additional immunosuppressors. Patients with pemphigus vulgaris usually have a poor prognosis while those who could survived more than 4 years usually have a better outcome.