Pemphigus Treatments

Medication

Drugs can usually help control symptoms. The medications can produce serious side effects. Your doctor may order periodic blood and urine tests to check for adverse effects.

Drugs that may be given include the following:

• Oral steroids, such as Prednisone
• Topical steroids, including injection into specific lesions
• Immunosuppressive drugs (drugs that decrease your immune system’s ability to function), such as:
  • Azathioprine (Imuran)
  • Mycophenylate Mofetil
  • Cyclophosphamide (Cytoxan)
  • Methotrexate
  • Gold
  • Cyclosporine
• Rituximab is monoclonal antibody against a protein on certain white blood cells active in pemphigus
• Antimalarial drugs such as hydroxychloroquine (Plaquenil)
• A combination of nicotinamide and tetracycline
• Antibiotics (topical or oral) to treat any bacterial skin infections that occur
• IV immunoglobulin
• Viscous lidocaine mouthwash may numb the mouth and provide pain relief
• Sucralfate mouthwash may coat and soothe the mouth and provide pain relief

Plasmapheresis

For this procedure, whole blood is removed and the plasma is separated. The packed cells are then suspended in saline are reinjected. This is used in certain cases in combination with immunosuppressive drugs.

Lifestyle Changes

Good nutrition helps the body heal and fight disease. Some foods may also make your symptoms worse or trigger the onset of more sores. Some patients notice they are sensitive to garlic, onions, and leeks. Keep track of the foods that seem to cause a reaction in your skin and avoid these foods. Read the labels of all foods to make sure they do not contain small amounts of foods that can set off a reaction.

Soft diets may be necessary if you have oral lesions.

Surgery

In some cases of paraneoplastic pemphigus, surgical removal of the tumor may improve the disorder or decrease symptoms.