The adjuvant therapy of pemphigus. An update

Systemic corticosteroids remain the mainstay of therapy for pemphigus. Their use has transformed what was almost invariably a fatal illness into one whose mortality is now below 10%. Unfortunately, the high doses and prolonged administration of corticosteroids that are often needed to control the disease result in numerous side effects, many of which are serious. Most patients who die of pemphigus at present die of complications of therapy. This has led to a continued search for alternative treatments that might reduce the need for steroids. Those treatments now in use are usually given in combination with steroids and, for that reason, are referred to as adjuvant therapies. This article summarizes progress in the adjuvant therapy of pemphigus since the last review of this subject 10 years ago.