[Therapy of pemphigus. Critical remarks based on 44 clinical cases]

The results are evaluated of therapy administered between 1957 and 1983 to 44 patients with pemphigus (28 pemphigus vulgaris, 5 pemphigus vegetans, 11 pemphigus seborrhoicus). The mean initial steroid dosage was 87 mg prednisone equivalent per day. The 5-year survival rate was 83%. Fifteen patients who were additionally treated with azathioprine during the initial phases of the disease had a 5-year survival rate of 100%. However, after having the disease for 5 years 41% of all pemphigus patients have to be rehospitalized. This percentage is only 21% in the group requiring less than 100 mg prednisone per day initially. Mortality related to pemphigus or infection occurs significantly earlier than cardiovascular deaths. The prognosis for survival is relatively good, but the prognosis for recovery remains uncertain. Combined therapy with corticosteroids and azathioprine in the early stages of the disease resulted in a 5-year survival rate of 100%, and is therefore recommended. However, even this therapeutic modality does not change the uncertain prognosis regarding recovery.