eMedicine Specialties > Dermatology > Bullous Diseases

Pemphigus Herpetiformis: Follow-up

Author: Lawrence Chan, MD, Department Head and Director of Skin Immunology Research, Professor, Departments of Dermatology and Microbiology/Immunology, University of Illinois College of Medicine
Contributor Information and Disclosures

Updated: Oct 15, 2008

Follow-up

Further Inpatient Care

The disease activities of pemphigus herpetiformis rarely require hospitalization. In a few patients, short-term hospitalization (<10 d) may be helpful.

Further Outpatient Care

The disease activities of pemphigus herpetiformis range from mild to moderate. During the active disease period, provide follow-up care for patients on a monthly outpatient basis. These visits ensure that (1) patients are responding clinically to prescribed medications and (2) patients experience no serious adverse effects that require a change of medications. Typically, follow-up visits are not needed for patients in clinical remission and not on treatment.

Deterrence/Prevention

For patients who are treated with systemic corticosteroid for longer than one month, a combined calcium and Vitamin D supplements should be instituted to prevent osteoporosis. The dosage and frequency of these supplements are stated in the 1996 recommendations established by the American College of Rheumatology Task Force.14

Prognosis

The prognosis for pemphigus herpetiformis usually is excellent.

Miscellaneous

Medicolegal Pitfalls

  • Failure to monitor patients receiving treatment with dapsone, since adverse effects may be severe
  • Failure to examine early signs of neuropathy, which is essential in patients receiving treatment with dapsone because of potential adverse effects
  • Failure to regularly obtain CBC counts, which is important in patients receiving treatment with dapsone to monitor potential adverse effects
  • Failure to investigate potential lung cancer associated with the disease when the patient has pulmonary symptoms
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous Chief Editor, William D. James, MD, to the development and writing of this article.



More on Pemphigus Herpetiformis

Overview: Pemphigus Herpetiformis
Differential Diagnoses & Workup: Pemphigus Herpetiformis
Treatment & Medication: Pemphigus Herpetiformis
Follow-up: Pemphigus Herpetiformis
Multimedia: Pemphigus Herpetiformis
References
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Further Reading

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Keywords

pemphigus herpetiformis, pemphigus, herpetiform pemphigus

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Contributor Information and Disclosures

Author

Lawrence Chan, MD, Department Head and Director of Skin Immunology Research, Professor, Departments of Dermatology and Microbiology/Immunology, University of Illinois College of Medicine
Lawrence Chan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Association of Professors of Dermatology, Chicago Dermatological Society, Dermatology Foundation, Illinois State Medical Society, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Medical Editor

Smeena Khan, MD, Private Practice, Adult and Pediatric Dermatology Associates
Smeena Khan, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey Meffert, MD, Assistant Clinical Professor of Dermatology, University of Texas Health Science Center-San Antonio
Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

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