Combination Therapy with Steroid Pulse Therapy and Plasmapheresis in the Treatment of Pemphigus

Abstract

We have treated 7 patients with pemphigus foliaceus and 1 patient with pemphigus vulgaris by the combination of corticosteroid pulse therapy and plasmapheresis. The skin lesions in 7 patients showed a dramatic improvement after this combination therapy. Dosage of the orally administered prednisolone has been reduced gradually without recurrence in 4 cases. Slight recurrence was observed in 3 cases long after completion of the combination therapy. We consider that the excellent therapeutic effect of this therapy depends on the direct removal of the anti-desmoglein antibodies by plasmapheresis and the suppression of inflammation and acantholysis by corticosteroid pulse therapy. This combination therapy can be recommended as the initial therapy for pemphigus.