Journal of Infectious Diseases & Preventive Medicine
Open Access
ISSN: 2329-8731
+44 1300 500008
ISSN: 2329-8731
+44 1300 500008
Maryam Zahed
Shiraz University of Medical Sciences, Iran
Scientific Tracks Abstracts: J Infect Dis Preve Med
Background: Pemphigus vulgaris (PV) is a chronic autoimmune mucocutaneous disease. Oral mucosa is a common site of involvement with treatment challenges. We studied the treatment outcomes of patients referred to the Oral Medicine Department of Shiraz University of Medical Sciences from 2004 to 2018 that were treated by a single protocol. Methods: This cross-sectional study was conducted on the medical records of 54 oral PV patients with histopathological confirmation. All patients were initially treated with 1 mg/kg/day oral prednisolone. After 4-6 weeks all patients were put on a 40 mg prednisolone regimen, and if lesion recovery was not observed or new lesions had developed, adjuvant therapy (starting dose of 200 mg per day of AZA) was initiated. The oral prednisolone dose was gradually tapered down in 9 months. Results: 47 patients were included in the study. 34.04% were male and 65.96% were female with the mean age of 41.83± 12.520. The severity of oral involvement was mild in 21.27%, moderate in 36.17%, and severe in 42.6%. The mean follow-up period was 50.806±44.417 months. The mean time to achieve complete remission was 150.39±224.075 days. Most of the patients experienced relapse due to self-discontinuation of treatment. 55% had complete remission and 43% were on partial remission at the last follow-up session. In 65.96% treatment side effects were observed. There was a significant difference in the number of patients with side effects in the prednisolone group vs prednisolone plus AZA group (80 % vs 50%, respectively; P = 0.030). The mean duration of treatment was longer for patients with side effects (P<0.01). No deaths were recorded. Conclusion: The results reveal that prescribing low-dose prednisolone and adding AZA in non-responding cases has good clinical outcomes. Adjuvant therapy can avoid the increase of corticosteroid dosage; reduce treatment time and side effects.
Maryam Zahed completed her studies at Shiraz University of Medical Sciences in Iran. She has done her research in Treatment of Oral Pemphigus Vulgaris with Corticosteroids and Azathioprine: A Long Term Study of 47 Cases.