Drug-Induced Pemphigus Treatment & Management

Updated: Mar 31, 2022
  • Author: Chris G Adigun, MD, FAAD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

Withdrawal of the offending agent is the first step in treatment. In addition, use of steroids (prednisolone) has shown to be an effective treatment for drug-induced pemphigus. [22] Most, but not all, patients go into remission once the offending agent is stopped. Some patients may follow a chronic course identical to that of idiopathic pemphigus vulgaris. These patients require systemic corticosteroids and/or immunosuppressive therapy. [26]

In a systematic review of 170 patients with drug-induced pemphigus, 25% of those whose symptoms were successfully resolved were treated solely with discontinuation of the offending drug. The remaining 75% required treatment with mainly azathioprine and/or topical and systemic corticosteroids. [27]

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Diet

Mucosal lesions may be exacerbated by eating hard or crunchy foods, such as potato chips, crackers, fresh fruits, and uncooked vegetables.

Certain foods that contain thiols and phenols should also be considered as inducers of pemphigus. Thiol-containing foods include garlic, chives, and onion; phenol-containing foods include mango, cashew, and black pepper. Foods containing these chemical properties are heavily consumed in India, thus suggesting an explanation for the higher prevalence and earlier onset of pemphigus in that country. [28]

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