Treating autoimmune dermatoses involves focusing on 3 phases: acute, maintenance, and supportive. Most patients require therapy for the remainder of their lives. Glucocorticoids at immunosuppressive doses are first-line therapy in the acute phase and may be sufficient for maintenance in some cases. Other immunosuppressive therapy includes azathioprine, cyclophosphamide, chlorambucil, and chrysotherapy (gold). Vitamin E has also been reported to have some beneficial effect.
Commentary: Although some forms of pemphigus are relatively benign, some, especially pemphigus vulgaris, may be fatal. Patients with vulgaris may have a positive Nikolsky sign (the skin is loose and when rubbed, slips free creating a new lesion). Patients will require lifelong treatment.
Diagnosis and treatment of common autoimmune skin diseases. MacDonald JM. WILD WEST VET CONF, October 2003.