Selection of the appropriate topical steroid strength and vehicle depends on the body site, age of the patient, and the potential for steroid side effects. Use of daily sunscreen and sun protection is necessary. Systemic therapy - Systemic steroids have been the mainstay of therapy for widespread pemphigus since their first use in 1950. Appropriate monitoring and follow-up to avoid steroid side effects is critical. Dapsone is effective in some patients with pemphigus erythematosus.
Patients tend to respond relatively quickly, with improvement within several weeks.
It can be a steroid-sparing drug. The possible mode of action is stabilization of lysosomal membranes and inhibition of PMN toxicity. Hemolytic jaundice may result in G6PD deficient people. Other side effects include agranulocytosis leading to death, headache, malaise, hepatitis, hypersensitivity reactions, and neuropathy. Caution is required.