摘要：

In dermatological (as well as in non-dermatological) disorders, stating a standard treatment, which may fit all varieties of a given disease and be suitable to every patient's requirements, is virtually impossible. Therefore this is only an attempt to outline some schemes for the management of pemphigus, taking account of the (a) clinical and histological variants of the disease, (b) possibility of combining well-known medicaments with new therapeutical methods, and (c) chance of using topical treatments alone in paucilesional forms. The corner-stone therapy for pemphigus encompasses corticosteroids and immunosuppressants, usually in association. These drugs can be given in a continuous high dosage or at exceedingly high but spaced out doses (pulse therapy), especially in life-threatening cases. Plasmapheresis is a valid alternative treatment in problem patients. Other medications and therapeutical methodologies usable for the management of pemphigus are gold salts, tetracyclines and niacinamide, high-dosed i.v. gammaglobulins, antimalarials, dapsone, photopheresis, hyperbaric oxygen. Useful suggestions for pemphigus patients derive from clinical and experimental observations on induced pemphigus. In particular, all drugs that proved to be capable of inducing or triggering the disease in genetically predisposed individuals should possibly be avoided. Exposure to the sun and other UV sources requires a special caution. Last but not least, pemphigus patients should be advised to have a balanced diet and avoid foods spiced with garlic and onion, since the culinary plants of the genus Allium contain some allyl compounds with a proven acantholytic potential.

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