Pemphigus was treated in 270 patients during the 40-year period before the introduction of steroid therapy and has been treated with steroids in 52 patients during a 4-year period since that time. The initial site of the bullae was the oral mucosa in nearly 55% of the cases. The mortality rate before steroids was more than 90%; in the steroid-treated series it was 33%. The steroids used were corticotropin, cortisone, hydrocortisone, and prednisone, and in the dosages needed to control the pemphigus they generally produced the characteristic side-effects, such as moon facies, hyperpigmentation, and psychotic symptoms. Two patients so treated died of gastrointestinal hemorrhages, which had not been observed in the presteroid series. Despite these disadvantages steroid therapy is at present the treatment of choice for pemphigus.
Costello MJ, Jaimovich L, Dannenberg M. TREATMENT OF PEMPHIGUS WITH CORTICOSTEROIDS: STUDY OF FIFTY-TWO PATIENTS. JAMA. 1957;165(10):1249–1255. doi:10.1001/jama.1957.02980280023007
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