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Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Pemphigus: a treatment update
Sue Jessop1, Nonhlanhla P Khumalo
1Division of Dermatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. susan.jessop@uct.ac.za
American Journal of Clinical Dermatology
|April 24, 2008
Summary
Current pemphigus treatments, including high-dose corticosteroids, have serious side effects. Evidence suggests moderate corticosteroid doses may be as effective, and newer therapies require more research.
Area of Science:
- Immunodermatology
- Autoimmune Bullous Disorders
Background:
- Pemphigus is a severe autoimmune blistering disease targeting keratinocyte adhesion.
- Current treatments like corticosteroids carry significant risks.
- Evidence for optimal pemphigus treatment strategies is limited.
Purpose of the Study:
- To review existing controlled trials on pemphigus treatment.
- To evaluate the efficacy and safety of different therapeutic approaches.
- To identify gaps in current research and guide future studies.
Main Methods:
- Literature review of 11 controlled trials (9 randomized) for pemphigus treatment.
- Analysis of trial data focusing on corticosteroid dosing and adjuvant therapies.
- Assessment of emerging treatments like biologics and immunotherapy.
Main Results:
- High-dose corticosteroids (pulse or daily) are not superior to moderate doses.
- Adjuvant immunosuppressive agents offer limited clinical benefit but may reduce corticosteroid needs.
- Newer therapies (rituximab, calcineurin inhibitors, immunoadsorption, peptide immunotherapy) show promise but lack robust trial data.
Conclusions:
- Optimal pemphigus treatment requires clinical judgment due to insufficient evidence.
- Large, multicenter randomized controlled trials are urgently needed.
- Further research into novel therapies like biologics and immunotherapy is warranted.
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