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Severe Pemphigus Foliaceus Treated With Extracorporeal Photochemotherapy

José M. Azaña, MD; Ricardo F. de Misa, MD; Antonio Harto, MD; Antonio Ledo, MD; Agustín España, MD
Arch Dermatol. 1997;133(3):287-289. doi:10.1001/archderm.1997.03890390021002.
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REPORT OF A CASE  A 64-year-old man presented with a 3-year history of severe pemphigus foliaceus. He had been treated with adequate doses of systemic corticosteroids, azathioprine sodium, intermittent methotrexate sodium, and cyclosporine. Maintenance treatment with prednisone (dose range, 40-60 mg/d) and azathioprine sodium (100 mg/d) was necessary to decrease new lesion formation. Nevertheless, he had 3 to 4 severe eruptions that required hospitalization (Figure 1 and Figure 2). Several adverse effects related to therapy were hypertension, cushingoid body habitus, and 1 episode of disseminated cutaneous herpetic infection.

THERAPEUTIC CHALLENGE  Systemic corticosteroids are the most useful drugs for the treatment of patients with pemphigus.1 Corticosteroids and immunosuppressive drugs may induce clinical remission in most patients. However, the adverse effects of these drugs are currently the most common cause of death in patients with pemphigus.1 Our patient had several adverse effects related to therapy and his disease was resistant


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