RESUMEN
Pephigus vulgaris is a recurrent life threatening disease. Its basic treatment is systemic steroids, after treating the first attack of the disease by systemic steroids we start to reduce the dose of the steroids gradually. During this reduction the desease may flare up, this recurrence is routinely treated by increasing the dose of the steroids again to control the disease, this study was made to compare the benefits of tetracycline in controlling the recurrence of pemphigus vulgaris with the routinely used way which is elevating the dose of prednisolone. this is a randomized controlled clinical trial where 38 patients of recurrent pemphigus vulgaris [during the period of reduction of steroids, mild to moderate recurrence], who visited the dermatology department in Damascus university between 29/12/2009-29/12/2010 ,were treated. they were divided into to groups :1-treatment with tetracycline [20 patients]:the dose of prednisolone which accompanied the recurrence was maintained and tetracycline was added [2 g / day].2-treatment with elevating the dose of prednisolone[18 patients]. The response and the side effects were studied .and the patients were followed up for at least 5 monthes after the treatment. good response was reported in 14 patients in the first group treated with tetracycline [70%], and in 14 patients in the second group treated with elevating the dose of prednisolone [77.78%]. So the response was equal in the 2 groups. And the response was faster in the first group [during 3 weeks only] while it was slower in the second group [it was as late as the 5th week in 2 patients]. The side effects of tetracycline were minimal and transit. while the side effects of steroids was less in the first group which treated with tetracycline [12 patients had side effects due to steroids while 8 patients didn't have any side effects of steroids] compared with the patients of the second group who were treated with elevating the dose of prednisolone [who had side effects of steroids in all of them '18 patients`]. tetracycline can be used in the rcurrance of pemphigus vulgaris which happened during the reduction of steroids with maintaining the dose of recurrence of prednisolone