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October 1976

Gold Compounds vs Corticosteroids in the Treatment of Pemphigus Vulgaris

Arch Dermatol. 1976;112(10):1466-1467. doi:10.1001/archderm.1976.01630340078025

To the Editor.—  Penneys et al1 have misinterpreted my earlier article on the use of corticosteroids in the treatment of pemphigus.2 On page 187 of my article, the correct quotation should be that 6 of 59 patients, not 49 (12%), were in remission. Details of therapy for this subgroup were as follows: all cases involved strictly oral lesions without trunk or extremity involvement; five patients' conditions were able to be managed with corticosteroids alone before remission; and one patient was in the pediatric age group and required both cyclophosphamide and corticosteroid therapy before remission was achieved. The findings of Penneys et al do not lead to the logical conclusion that chrysotherapy is the treatment of choice for pemphigus following initial control with corticosteroids when necessary. The nephrotic syndrome and agranulocytosis are not benign complications, and it is well known from the experience with chrysotherapy in the treatment