Evidence-Based Treatment for a Patient with Oral Pemphigus_Chinese Journal of Evidence-Based Medicine

Authors：

1. Department of Dermatovenereology; West China Hospital; Sichuan University; Chengdu 610041; China2. Chinese Evidence-Based Medicine Center3. Department of Gerontology;

Corresponding author：

Keywords：

Pemphigus; Evidence-based treatment

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To explore the methods of evidence-based individualized treatment for a patient with oral pemphigus.
Methods 　According to chnical problems, we searched The Coehrane Library （Issue 1,2005 ） , MEDLINE （1966 -Jan. 2005 ）, SUMSEAR.CH （Jan. 2005 ）, TRIPDATABASE （1997 - 2005 ）, CMCC （1994 - 2004 ）and handsearched four Chinease journals （starting pubhcation -2004）.
Results 　No Systematic review was found. Six randomised controlled trials, two reviews of high quality and one guidehne were identified. We found that corticosteroid was the firsthne medicine in the treatment of pemphigus. However, corticosteroid at higher dose did not work more effectively than that at lower dose. Corticosteroid at middle-dose was preferred in treating oral pemphigus. Additionally, corticosteroid combined with immunosuppressants led to lower mortality. Among them, cyclophosphamide and azathioprine were recommended, and methopterin should be avoided. Plasma exchange in combination with corticosteroid at lowor middle-dose should not be recommended in conventional therapy. Chinese traditional treatment combined with Western medicine might work. A treatment with prednisone at the dose of 60 mg/d and in combination with azathioprine 100mg/d was made based on the evaluation of the data available and was proved optimal by 6 months following-up.
Conclusions 　The therapeutic effect of pemphigus has been improved by evidence-based treatment.

Citation： Li Wei,Wei MaoLing,Li JingYi,Xiong Lin,Dong BiRong. Evidence-Based Treatment for a Patient with Oral Pemphigus. Chinese Journal of Evidence-Based Medicine, 2005, 05(9): 715-717. doi: Copy

1.	骆肖群, 祝禄川, 陶玲娣, 苏玮, 傅海军, 郑志忠, 蔡定芳, 翁孟武. 中西医结合治疗天疱疮的疗效观察[J]. 临床皮肤科杂志, 2003; 32(1): 38～41.
2.	刘根起, 陈树民. 寻常型天疱疮的治疗、缓解模式和预后[J]. 国外医学皮肤性病学分册, 2004; 30(2): 69～71.
3.	朱学骏, 李冠群, 万里明, 马蓉芳. 60例天疱疮的皮质类固醇治疗及预后观察[J]. 临床皮肤科杂志, 1993; 22(4): 190～192.
4.	余建斌, 尹光文, 王宏瑾, 李冬芹, 傅世珍, 李景月. 环磷酰胺冲击治疗寻常型天疱疮患者的剂量与近期疗效分析[J]. 中华皮肤科杂志, 1999; 32(7): 271～272.
5.	Luo X, Zhu L, Tao L, Su W, Fu H, Zheng Z, Cai D, Weng M. The clinical and laboratory research for Chinease traditional medicine in the treatment of pemphigus[J]. J Clin Dermato, 2003; 32(1): 38-41.
6.	Liu G, Chen S. Treatment, patterns of remission and prognosis in pemphigus vulguris[J]. F Med Sci Sec Dermatol Venereol, 2004; 30(2): 69-71.
7.	Ratnam KV, Phay KL, Tan CK. Pemphigus therapy with oral prednisolone regimens[J]. A 5-year study. Int J Dermatol, 1990; 29(5): 363-367.
8.	Zhu X, Li G, Wan L, Ma R. Observation corticosteroid treatment and prognosis of 60 pemphigus patients[J].J Clin Dermato, 1993; 22(4): 190-192.
9.	Carson PJ, Hameed A, Ahmed AR. Influence of treatment on the clinical course of pemphigus vulgaris[J]. J Am Acad Dermatol, 1996; 34(4): 645-652.
10.	Shehata N, Kouroukis C, Kelton JG. A review of randomized controlled trials using therapeutic apheresis[J]. Transfusion Medicine Reviews, 2002; 16(3): 200-229.
11.	Harman KE, Albert S, Black MM. Guidelines for the management of pemphigus vulgaris[J]. Br J Dermatol, 2003;149(5): 926-937.
12.	Chrysomallis F, Ioannides D, Teknetzis A, Panagiotidou D, Minas A. Treatment of oral pemphigus vulgaris[J]. Int J Dermatol, 1994; 33(11): 803-807.
13.	Ioannides D, Chrysomallis F, Bystryn JC. Ineffectiveness of cyclosporine as an adjuvant to corticosteroids in the treatment of pemphigus[J]. Arch Dermatol, 2000; 136(7): 868-872.
14.	Yu J, Yun G, Wang H, Li D, Fu S, Li J. Analysis of dosage and therapeutic effect in the near future with cyclophosphamide pulse therapy in the treatment of pemphigus vulgaris[J]. Chin J Dermatol, 1999; 32(7): 271-272.
15.	Guillaume JC, Roujeau JC, Morel P, Doutre MS, Guillot B, Lambert D, Lauret P. Controlled study of plasma exchange in pemphigus[J]. Arch Dermatol, 1988; 124(11): 1659-1663.

1. 骆肖群, 祝禄川, 陶玲娣, 苏玮, 傅海军, 郑志忠, 蔡定芳, 翁孟武. 中西医结合治疗天疱疮的疗效观察[J]. 临床皮肤科杂志, 2003; 32(1): 38～41.
2. 刘根起, 陈树民. 寻常型天疱疮的治疗、缓解模式和预后[J]. 国外医学皮肤性病学分册, 2004; 30(2): 69～71.
3. 朱学骏, 李冠群, 万里明, 马蓉芳. 60例天疱疮的皮质类固醇治疗及预后观察[J]. 临床皮肤科杂志, 1993; 22(4): 190～192.
4. 余建斌, 尹光文, 王宏瑾, 李冬芹, 傅世珍, 李景月. 环磷酰胺冲击治疗寻常型天疱疮患者的剂量与近期疗效分析[J]. 中华皮肤科杂志, 1999; 32(7): 271～272.
5. Luo X, Zhu L, Tao L, Su W, Fu H, Zheng Z, Cai D, Weng M. The clinical and laboratory research for Chinease traditional medicine in the treatment of pemphigus[J]. J Clin Dermato, 2003; 32(1): 38-41.
6. Liu G, Chen S. Treatment, patterns of remission and prognosis in pemphigus vulguris[J]. F Med Sci Sec Dermatol Venereol, 2004; 30(2): 69-71.
7. Ratnam KV, Phay KL, Tan CK. Pemphigus therapy with oral prednisolone regimens[J]. A 5-year study. Int J Dermatol, 1990; 29(5): 363-367.
8. Zhu X, Li G, Wan L, Ma R. Observation corticosteroid treatment and prognosis of 60 pemphigus patients[J].J Clin Dermato, 1993; 22(4): 190-192.
9. Carson PJ, Hameed A, Ahmed AR. Influence of treatment on the clinical course of pemphigus vulgaris[J]. J Am Acad Dermatol, 1996; 34(4): 645-652.
10. Shehata N, Kouroukis C, Kelton JG. A review of randomized controlled trials using therapeutic apheresis[J]. Transfusion Medicine Reviews, 2002; 16(3): 200-229.
11. Harman KE, Albert S, Black MM. Guidelines for the management of pemphigus vulgaris[J]. Br J Dermatol, 2003;149(5): 926-937.
12. Chrysomallis F, Ioannides D, Teknetzis A, Panagiotidou D, Minas A. Treatment of oral pemphigus vulgaris[J]. Int J Dermatol, 1994; 33(11): 803-807.
13. Ioannides D, Chrysomallis F, Bystryn JC. Ineffectiveness of cyclosporine as an adjuvant to corticosteroids in the treatment of pemphigus[J]. Arch Dermatol, 2000; 136(7): 868-872.
14. Yu J, Yun G, Wang H, Li D, Fu S, Li J. Analysis of dosage and therapeutic effect in the near future with cyclophosphamide pulse therapy in the treatment of pemphigus vulgaris[J]. Chin J Dermatol, 1999; 32(7): 271-272.
15. Guillaume JC, Roujeau JC, Morel P, Doutre MS, Guillot B, Lambert D, Lauret P. Controlled study of plasma exchange in pemphigus[J]. Arch Dermatol, 1988; 124(11): 1659-1663.

Chinese Journal of Evidence-Based Medicine

Evidence-Based Treatment for a Patient with Oral Pemphigus

Abstract Full text Figures/Tables Video References Cited by

Format

Content