Pemphigus Vulgaris Treatment Focuses on Healing Blisters and Preventing New Ones from Forming
Pemphigus vulgaris is a widespread auto-immune disorder which causes inflammation of the skin, particularly the mucous membranes, within the mouth and nose. It occurs almost exclusively in middle-aged or older people. The primary lesion of pemphigus vulgaris is a soft blister filled with clear fluid that appears on healthy or irritated skin. The condition occurs when the immune system mistakenly makes antibodies against proteins in healthy skin and mucous membranes. The antibodies break down the bonds between the cells, and fluid collects between the layers of the skin. This leads to blisters and erosions on the skin.
Patients are usually diagnosed when they have persistent or recurrent redness, thickening, itching or bleeding of the mucous membranes in the nose and cheeks. The primary objective of the therapeutic management of pemphigus vulgaris is initially to control the disease, heal the bullous skin and mucous lesions, and minimize the associated functional impairment. Azathioprine and cyclophosphamide are usually the main pemphigus vulgaris treatment. In mild and moderate cases of pemphigus vulgaris, oral immunosuppressant drugs (cyclophosphamide or methotrexate) are the usual treatment of choice.
There’s currently no cure for pemphigus vulgaris, but treatment can help keep the symptoms under control. The main aim of pemphigus vulgaris treatment is to heal the blisters and prevent new ones forming. Doctors usually prescribe immunosuppressant drugs such as cyclophosphamide or methotrexate. These drugs can prevent the immune system from attacking the mucous lining in the lungs, thus reducing the inflammation and symptoms associated with the condition.
Use of steroids in pemphigus vulgaris treatment can help reduce the harmful activity of the immune system in a short space of time. A doctor may suggest a high dose to get the symptoms under control. The use of steroids can be reduced to the lowest possible dose once your symptoms are under control. A high dose can lead to increased appetite and weight gain, diabetes, thin skin, increased risk of infections, acne, and high blood pressure. Other immunosuppressants used in pemphigus vulgaris treatment include azathioprine, mycophenolate mofetil, ciclosporin and cyclophosphamide. In mild pemphigus vulgaris, corticosteroids are prescribes that can be applied to the skin. Many people need stronger medicine like prednisone or methylprednisolone. These corticosteroids work throughout the body. Use of RCTs with adjuvant therapy with azathioprine, mycophenolate mofetil, cyclophosphamide, cyclosporine, intravenous immunoglobulin, plasma exchange, and infliximab in pemphigus vulgaris treatment is not beneficial for achieving remission.
Immunosuppressants can stop the body from creating new blisters. This pemphigus vulgaris treatment suppresses the immune system. Either azathioprine or mycophenalate mofetil is often used to treat pemphigus. Along with immunosuppressants, antibiotic, antiviral, and antifungal drugs are also used in the treatment plan. Biologics are emerging treatment option. Rituximab offers potential in the treatment of pemphigus vulgaris and is safe. Several other pemphigus vulgaris treatment are sometimes used in combination with steroid medication that include, tetracycline and dapsone, plasmapheresis, and intravenous immunoglobulin therapy.
