Kar P K
Classified Specialist (Derm & STD), Department of Dermatology and STD, 151 Base Hospital. C/o 99 APO.
Med J Armed Forces India. 1998 Jul;54(3):243-246. doi: 10.1016/S0377-1237(17)30554-3. Epub 2017 Jun 26.
Pemphigus vulgaris is perhaps the most formidable disease encountered by dermatologists. In the days before steroid therapy the mortality rate was 95 per cent, death occuring usually within 14 months. The cause of death was septicaemia, starvation and toxic state. Corticosteroid, immunosuppressants and adjuvant therapy have reduced the mortality to 10-40 per cent with the cause of death being uncontrolled pemphigus, complications of corticosteroid and immunosuppressant therapy, septicaemia and thromboembolism. Elderly patients and patients with extensive lesions have higher mortality rate. Prognosis has further improved by intensive care, adequate fluid replacement, nutritional support, a co-herent antibacterial policy alongwith aggressive corticosteroid therapy and immunosuppressants. Plasmapheresis has been used in patients who fail to respond to conventional management. Extracorporeal photophoresis has been reported to be effective in patients with 'treatment resistance' pemphigus vulgaris.
寻常型天疱疮可能是皮肤科医生所遇到的最棘手的疾病。在使用类固醇治疗之前的日子里，死亡率为95%，死亡通常发生在14个月内。死因是败血症、饥饿和中毒状态。皮质类固醇、免疫抑制剂和辅助治疗已将死亡率降低至10%-40%，死因是未得到控制的天疱疮、皮质类固醇和免疫抑制剂治疗的并发症、败血症和血栓栓塞。老年患者和皮损广泛的患者死亡率较高。通过重症监护、充足的液体补充、营养支持、连贯的抗菌策略以及积极的皮质类固醇治疗和免疫抑制剂，预后已进一步改善。血浆置换已用于对传统治疗无反应的患者。据报道，体外光化学疗法对“治疗抵抗性”寻常型天疱疮患者有效。
