management of oral pemphigus vulgaris with systemic corticosteroid and dapsone

ABSTRACT

Oral pemphigus vulgaris is a chronic autoimmune mucocutaneous intraepithelial disease that primarily affects patients over the age of fifty, resulting in mucosal ulceration and is a potentially life-threatening disease. The purpose of this study was to investigate the efficacy of dapsone in combination with systemic corticosteroids to treat the oral lesions of oral pemphigus. Twenty patients diagnosed with oral pemphigus were selected. Oral manifestations were graded according to the severity of disease from 1 to 3. All patients were treated initially with systemic corticosteroids. Each was assigned to one of 4 groups according to their response to therapy. Patients who responded less than 50% healing of lesions began a trial of dapsone. After 4 weeks, signs and symptoms were recorded, and if a patient was lesion-free, the dapsone dosage was gradually tapered. Five patients with mild to moderate disease were treated with systemic corticosteroids alone. 15 patients with moderate to severe disease were treated with systemic corticosteroid and dapsone therapy. Of these, 10 patients had significant benefits, while 5 patients did not respond to dapsone adjuvant. The use of dapsone in combination with systemic corticosteroids is a useful method for treatment of oral pemphigus