Dehen L, Crickx B, Grossin M, Belaïch S
Service de Dermatologie, Hôpital Bichat, Paris.
Ann Dermatol Venereol. 1993;120(12):874-8.
Traditionally, the prognosis of pemphigus erythematosus is thought to be more favourable than that of pemphigus vulgaris. A retrospective study of the records of 10 patients with pemphigus erythematosus and 13 patients with pemphigus vulgaris was set up to compare the courses of the two diseases. This comparison, carried out in populations with similar age, sex ratio, pretreatment duration of the disease and treatment received, showed that relapses were more frequent in the course of pemphigus erythematosus, whereas remissions, mean duration of the disease and iatrogenic complications were the same in both groups. This study, therefore, throws some doubts on the dogma of relative mildness of pemphigus erythematosus, which goes back to a period long before systemic corticosteroid therapy was known. Mortality studies performed since the event of this treatment have shown that the prognosis had improved and tended to be the same in both diseases. The other data concerning the course of treated pemphigus erythematosus are little known and were never compared with those concerning pemphigus vulgaris. Our study shows that treatments similar to those of pemphigus vulgaris are necessary to obtain remissions in pemphigus erythematosus and that these diseases share the same evolutive profile. However, the question of the best therapeutic strategy to be used has not yet been answered.
传统上，红斑型天疱疮的预后被认为比寻常型天疱疮更乐观。一项对10例红斑型天疱疮患者和13例寻常型天疱疮患者的记录进行的回顾性研究，旨在比较这两种疾病的病程。在年龄、性别比例、疾病治疗前持续时间和接受治疗相似的人群中进行的这种比较表明，红斑型天疱疮病程中复发更频繁，而两组的缓解情况、疾病平均持续时间和医源性并发症相同。因此，这项研究对红斑型天疱疮相对轻症这一教条提出了一些质疑，这一教条可以追溯到全身糖皮质激素治疗出现之前的很长一段时间。自从这种治疗方法出现以来进行的死亡率研究表明，预后有所改善，且两种疾病的预后趋于相同。其他关于接受治疗的红斑型天疱疮病程的数据鲜为人知，也从未与寻常型天疱疮的数据进行过比较。我们的研究表明，要使红斑型天疱疮缓解，需要采用与寻常型天疱疮相似的治疗方法，并且这两种疾病具有相同的演变特征。然而，最佳治疗策略的问题尚未得到解答。
