This protocol covers first-line management of pemphigus vulgaris presenting as mild disease — with limited body surface area involvement and oral lesions that do not impair eating or require analgesics.
Pemphigus vulgaris with involved body surface area (BSA) below 5% and limited oral lesions not impairing food intake or requiring analgesics, and/or a PDAI score of 15 or less.
First-line options for this mild presentation include targeted biologic therapy — used alone or combined with a short corticosteroid course — as well as systemic corticosteroid-based regimens with or without adjuvant immunosuppression.
Disease control achieved.
DOI: 10.1111/jdv.16752
PV with involved body surface area (BSA) < 5% and limited oral lesions not impairing food intake or requiring analgesics.
PDAI score ≤ 15.
Rituximab: two infusions of 1g two weeks apart, alone, or associated with oral prednisone 0.5 mg/kg/day with a rapid decrease in order to stop corticosteroids after 3 or 4 months.
Systemic corticosteroids: prednisone 0.5–1.0 mg/kg/day with or without azathioprine (2.0 mg/kg/d), or mycophenolate mofetil 2 g/day or mycophenolate sodium 1440 mg/d.
Disease control achieved.
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