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Do Safe and Effective Treatment Options Exist for Patients With Active Pemphigus Vulgaris Who Plan Conception and Pregnancy?
Julia S. Lehman, MD;
Kurt K. Mueller, MD;
Daniel F. Schraith, MD
Arch Dermatol. 2008;144(6):783-785.
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Clinical Question
A 32-year-old woman with active pemphigus vulgaris (PV) who planned to conceive in the near future presented to our dermatology clinic to discuss pharmacologic management of her PV. At that time, she had stable but persistent oral disease while prescribed a regimen of prednisone, 7.5 mg/d; dapsone, 50 mg twice daily; and methotrexate, 25 mg/wk. The objective of this article is to evaluate available evidence regarding the safety and efficacy of steroid-sparing agents in PV during the peripartum period.
Background
Pemphigus vulgaris in pregnancy is rare, with fewer than 40 cases documented in the literature.1 Avoidance of immunosuppressive medications in patients with PV during pregnancy has been recommended,2 but this cannot be achieved in many cases because inadequate treatment of PV can contribute to marked patient morbidity and mortality.3-4 Moreover, severe maternal disease and high serum antibody titers previously . . . [Full Text of this Article]
Literature Search
Appraisal of the Evidence
Limitations of the Critically Appraised Topic
Clinical Bottom Line
What Happened to Our Patient?
AUTHOR INFORMATION
Transitional Residency Program (Dr Lehman) and Departments of Dermatology (Dr Mueller) and Pathology (Dr Schraith), Gundersen Lutheran Medical Center, La Crosse, Wisconsin. Dr Lehman is now with the Department of Dermatology, Mayo School of Graduate Medical Education, Rochester, Minnesota.
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