Alternate-day prednisone, in a starting oral dose of 160 mg every other morning, has effectively controlled previously untreated mild to moderately severe pemphigus vulgaris (PV) in three patients. Titers of pemphigus-type, intercellular antibodies decreased during treatment and roughly paralleled clinical improvement. The lack of serious side effects, normal pituitary-adrenal function, and intact delayed hypersensitivity responses with this treatment schedule suggest that there are definite advantages over conventional daily, divided-dose corticoid regimens. This type of alternate-day prednisone regimen in adequate doses also has been effective in controlling a second group of patients with PV who had been treated previously with prednisone in two or four doses daily. Further experience with alternate-day prednisone therapy is needed in order to determine whether such a schedule could be the treatment of choice in mild and moderately severe PV.
Rabhan NB, Kopf AW. Alternate-Day Prednisone Therapy for Pemphigus VulgarisPreliminary Report. Arch Dermatol. 1971;103(6):615-622. doi:10.1001/archderm.1971.04000180041005