Curative Treatment for Pemphigus

Abstract

The recent article by Bystryn and Steinman 1 is an excellent review of pemphigus treatments but did not discuss the impact of the dexamethasonecyclophosphamide pulse (DCP) therapy regimen as we use it. We would like to describe the long-term follow-up of 79 patients we described 8 years ago 2 to substantiate our claim that the DCP therapy regimen can indeed cure pemphigus. 2-4 Briefly, the DCP regimen consists of administering dexamethasone (100 mg) intravenously on 3 consecutive days along with cyclophosphamide (500 mg) on 1 of these days and repeating DCP treatment at exactly 28-day intervals 2-7 In between the DCP doses, the patient receives only cyclophosphamide (50 mg/d orally). During the early part of the therapy most patients develop clinical lesions in between the DCP treatments, but the disease becomes progressively milder until the patient is in complete clinical remission (phase 1). After this, the patient is given 6 more