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Diseases

Genetic and Rare Diseases Information Center (GARD)

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Your Question

Are there medications besides prednisone which can successfully treat pemphigus? What about "alternative" medical treatments?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is pemphigus?

Pemphigus is a group of rare autoimmune diseases that cause blistering of the skin and mucous membranes (mouth, nose, throat, eyes, and genitals).[1] This condition can occur at any age, but often strikes people in middle or older age. It is more common in people of Middle Eastern or Jewish descent than in other races and cultures. Pemphigus is a chronic disease which is best controlled by early diagnosis and treatment.[2] Treatment includes steroids to reduce inflammation, drugs that suppress the immune system response and antibiotics to treat associated infections.[3]

There are three main types of pemphigus:[2]

  • Pemphigus vulgaris
  • Pemphigus foliaceus 
  • Paraneoplastic pemphigus
  • Last updated: 3/3/2010

    How is pemphigus treated?

    High-dose oral corticosteroids, such as prednisone or prednisolone, are the main treatment for pemphigus. These are anti-inflammatory medicines that suppress the immune system.[1] High doses are often required to bring pemphigus under control. To keep the levels of corticosteroid use to a minimum, immunosuppressive drugs are often added to a patient’s treatment. These drugs stop or slow down the immune system’s response to what it sees as an attack on the body. They include:[1][4]

    Once controlled, the steroid is reduced slowly to minimize side effects. Some patients then go into remission; however, many patients need a small maintenance dose to keep the disease under control.[4]

    Last updated: 3/3/2010

    Some people cannot take or do not respond to prednisione. Are there other medications which can be used to treat this condition?

    People with severe pemphigus that cannot be controlled with corticosteroids may undergo plasmapheresis, a treatment in which the blood containing the damaging antibodies is removed and replaced with blood that is free of antibodies. Such patients can also be treated with IVIg, or intravenous immunoglobulin, which is given daily for 3 to 5 days, every 2 to 4 weeks for 1 to several months.[1] Plasmapheresis and IVIg are both very expensive treatments, since they require large amounts of donated and specially processed blood.[1][4] Scientists have reported success in treating difficult cases of pemphigus vulgaris with a combination of IVIg and rituximab, a cancer medication.[1]

    Other drugs that are used routinely with varying effects include:[1][4]

    To learn more about new medications being studied for the treatment of pemphigus, visit the ClinicalTrials.gov web site.

    Last updated: 3/3/2010

    Are there any 'alternative' treatments for pemphigus?

    To date, no studies have shown that alternative, homeopathic, or any other non-traditional method has been successful in treating pemphigus. However, alternative therapies may be useful to help reduce drug side effects, once the disease is under control.[4]
    Last updated: 3/3/2010

    References