Treatment for Pemphigus Vulgaris ?

Treatment is aimed at reducing pain and symptoms and preventing complications like infection. It involves one or more drugs and other methods. It may include any of the following:

Corticosteroids and immune-suppressing drugs

A high dose of corticosteroids is the core treatment for the condition. Common corticosteroids include prednisone or prednisolone. A high dose is usually needed to control the condition at first.

These drugs have many side effects, including:

  • an increased likelihood of becoming infected
  • Osteoporosis
  • Cataracts
  • Glaucoma
  • increased blood sugar
  • Diabetes
  • a loss of muscle mass
  • Stomach ulcers
  • water retention

You may need to take supplements such as calcium and vitamin D, eat a low-sugar diet, or take other medications to treat these side effects. Once the blisters are under control, the dose may be lowered to the lowest level needed to prevent new blisters and to keep the side effects at a minimum. A corticosteroid cream can be used directly on the blisters as well.

To help keep the dose of corticosteroids low, your doctor may prescribe additional medications that suppress the immune system. These include:

  • azathioprine
  • mycophenolate mofetil
  • methotrexate
  • cyclophosphamide
  • rituximab

Antibiotics, antivirals, and antifungals

Any of these may be prescribed to prevent other infections.

Intravenous (IV) feeding

If your mouth ulcers are severe, you may not be able to eat without pain. You may need to be fed through your veins. This involves using an intravenous (IV) connection.


In very severe cases, a person may undergo a procedure known as plasmapheresis. This procedure is intended to remove the antibodies attacking the skin from the blood. During this procedure, the plasma, or fluid part of the blood, is removed by a device and replaced with donated plasma. This treatment can be very expensive.

Wound management

If the blisters are severe, you may need to stay in the hospital to get wound treatment. This treatment is similar to what’s given for severe burns. You may need to receive IV fluids and electrolytes if you’ve lost too much fluid through oozing of the blisters.

The treatment for the blisters may also include:

  • numbing lozenges for mouth blisters
  • soothing lotions
  • wet dressings
  • pain medications
  • soft-food diets
  • avoidance of spicy or acidic foods that may irritate the blisters
  • avoidance of too much sun exposure


If the blisters in your mouth keep you from brushing or flossing your teeth, you may need special oral health treatment to prevent gum disease and tooth decay. See your dentist to ask them about oral care.