Vyas Nikki, Patel Nishit S, Cohen George F
University of South Florida Morsani College of Medicine, Tampa, FL, USA.
J Drugs Dermatol. 2013 Feb;12(2):210-6.
Pemphigus vulgaris (PV) is a life-threatening autoimmune bullous disorder. Although systemic corticosteroids are the standard treatment for PV, efficient transition to a steroid-sparing immunosuppressant is critical. There is significant debate in the literature as to what the optimal, first-line steroid-sparing agent should be in patients with PV. Mycophenolate mofetil (MMF), in particular, is a promising agent that should be strongly considered as a first-line steroid-sparing agent. The authors review treatment options for PV and describe a severe case treated successfully with prednisone and MMF as a first-line steroid-sparing agent. The patient's clinical improvement was rapid, and all PV lesions completely resolved. The dosage of prednisone was safely tapered using MMF, and the patient did not experience any flares or significant side effects during the course of treatment. Therapy for PV with systemic corticosteroids and MMF therapy was effective and well tolerated.
寻常型天疱疮（PV）是一种危及生命的自身免疫性大疱性疾病。尽管全身用糖皮质激素是PV的标准治疗方法，但有效过渡到一种可减少激素用量的免疫抑制剂至关重要。关于PV患者最佳的一线减少激素用量药物应该是什么，文献中存在重大争议。特别是霉酚酸酯（MMF），是一种有前景的药物，应被强烈视为一线减少激素用量药物。作者回顾了PV的治疗选择，并描述了一例成功用泼尼松和MMF作为一线减少激素用量药物治疗的严重病例。患者的临床症状迅速改善，所有PV皮损完全消退。使用MMF安全地逐渐减少了泼尼松的用量，且患者在治疗过程中未出现任何病情复发或明显副作用。全身用糖皮质激素联合MMF治疗PV有效且耐受性良好。
