ABSTRACT

Background:

Pemphigus group diseases have high mortality and morbidity. The mainstay of pemphigus treatment is systemic high dose corticosteroids. However, the long-term use of high dose corticosteroids is impossible due to their side effects. Adjuvant drugs are added either at the time of diagnosis of the disease together with systemic corticosteroids or during dose tapering of corticosteroids or at disease flare-ups. The most commonly used adjuvant drugs are Azatioprine and Mycophenolate. Although both of these drugs decrease the yearly cumulative corticosteroid dose of a pemphigus patient, the corticosteroid sparing effect of Azathioprine is stronger. Both of these drugs are immunosupressants and have several side effects; Mycophenolate’s side effects are more tolerable compared to Azathioprine. Dapsone, methothrexate, cyclosporine, tetracycline derivatives and niacin are other adjuvant drugs that are used less commonly.