A summary of our results is presented in Table 1. Twenty-six patients with pemphigus were treated with gold: 4 with gold alone and 22 with prednisone and gold. Twenty-two patients (85%) responded to therapy with gold. A response was defined as improvement of blistering and ability to significantly decrease prednisone dosage to less than 20 mg/d or complete discontinuation. Four patients (patients 3, 4, 15, and 16) were in complete remission (discontinued gold and prednisone therapy and free of disease) at the end of the study. Only 1 of these patients (patient 15) has had a mild relapse of disease, requiring only gold therapy to achieve control. Seven patients (patients 1, 5, 7, 8, 17, 19, and 22) discontinued use of prednisone and were free of disease at the end of the study, but were still receiving gold. Four of these patients (patients 1, 5, 7, and 8) have had mild recurrences that responded to short (<2-month) courses of prednisone. Five patients (patients 6, 10, 12, 13, and 20) responded to gold therapy but were still receiving prednisone and gold and had some degree of blistering at the end of the study. None of the disease exacerbations in patients who responded have been as severe as that at presentation. Patients 5 through 22 were able to decrease their daily prednisone dosage by half, suggesting that gold produced a lower steroid requirement to control disease. The average dosage of prednisone before gold therapy was initiated in patients 5 through 22 was 55 mg/d (range, 10-100 mg/d). The average dosage of prednisone in those who were still receiving steroids at the end of the study was 9 mg/d (range, 5-20 mg/d). No adjuvants other than gold were given during the course of the study.