Mucous membrane manifestations of pemphigus vulgaris. A 25-year survey of 185 patients treated with corticosteroids or with combination of corticosteroids with methotrexate or heparin.

One hundred and eighty-five patients with pemphigus vulgaris were treated and followed up over a period of 25 years, from 1962 to 1987, at the Department of Dermatology of Moscow Medical Stomatological Institute. In all these patients the diagnosis was confirmed clinically, histologically and cytologically, and in 152 patients by means of direct and indirect immunofluorescence. The patients were treated with corticosteroids or with a combination of corticosteroids with methotrexate or heparin. The initial manifestations of the disease and their development at the period before the treatment and during therapy were studied. The optimum regimens of the maintenance treatment were investigated including those in 31 patients whom the treatment could be discontinued. The treatment-related complications and 28 cases with fatal outcome are analysed.