Powell A M, Albert S, Al Fares S, Harman K E, Setterfield J, Bhogal B, Black M M
Department of Immunofluorescence, St John's Institute of Dermatology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, U.K.
Br J Dermatol. 2003 Jul;149(1):138-45. doi: 10.1046/j.1365-2133.2003.05269.x.
Pemphigus is a group of autoimmune blistering diseases of the skin and/or mucous membranes requiring management with immunosuppressive therapy. The optimal therapeutic regimen would rapidly induce remission and maintain effectiveness with minimal adverse effects in the long term.
The present study describes our experience of the addition of mycophenolate mofetil (MMF) to prednisolone in the management of severe, refractory pemphigus.
Patients with active, refractory pemphigus were treated with MMF. Our series included 12 cases of pemphigus vulgaris, four cases of pemphigus foliaceous and one case of paraneoplastic pemphigus. All patients were monitored to assess disease control and mycophenolate toxicity.
Of the 17 cases, MMF has been of benefit to 12. MMF was well tolerated and there were no treatment withdrawals because of safety concerns.
We found that MMF permitted a reduction in prednisolone dosage without disease relapse.
天疱疮是一组皮肤和/或黏膜的自身免疫性水疱病，需要采用免疫抑制疗法进行治疗。最佳治疗方案应能迅速诱导缓解，并在长期内以最小的不良反应维持疗效。
本研究描述了我们在重症、难治性天疱疮的治疗中，将霉酚酸酯（MMF）添加到泼尼松龙治疗中的经验。
对活动性、难治性天疱疮患者采用MMF治疗。我们的系列病例包括12例寻常型天疱疮、4例落叶型天疱疮和1例副肿瘤性天疱疮。对所有患者进行监测，以评估疾病控制情况和霉酚酸酯的毒性。
在这17例患者中，12例从MMF治疗中获益。MMF耐受性良好，没有因安全问题而停药的情况。
我们发现MMF可在不导致疾病复发的情况下减少泼尼松龙的剂量。
