{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T14:48:13Z","timestamp":1778510893039,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,2,16]],"date-time":"2005-02-16T00:00:00Z","timestamp":1108512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2005,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p> <jats:italic>Background:<\/jats:italic> Pemphigus is a potentially life\u2010threatening autoimmune blistering skin disease usually treated with high\u2010dose corticosteroids in combination with immunosuppressive drugs. In a multicenter, prospectively randomized study we compared efficacy and side effects of a dexamethasone\u2010cyclophosphamide (D\/C) pulse therapy with a methylprednisolone\u2010azathioprine (M\/A) therapy in 22\u2005patients with newly diagnosed pemphigus vulgaris and pemphigus foliaceus.<\/jats:p><jats:p> <jats:italic>Patients and methods:<\/jats:italic> The 11\u2005patients of the M\/A group were treated with daily doses of methylprednisolone (initially 2\u2005mg\/kg body weight) and azathioprine (2\u200a\u2013\u200a2,5\u2005mg\/kg body weight) which were subsequently tapered. D\/C pulse therapy in 11\u2005patients consisted of intravenous administration of 100\u2005mg dexamethasone\/d on 3 consecutive days along with cyclophosphamide (500\u2005mg) on day one. Pulses were initially repeated every 2\u200a\u2013\u200a4 weeks and then at increasing intervals. In between the pulses, oral cyclophosphamide (50\u2005mg) was given daily for 6\u2005months.<\/jats:p><jats:p> <jats:italic>Results:<\/jats:italic> Within 24\u2005months after treatment initiation, 5\/11\u2005patients of the D\/C group had a remission (complete remissions after discontinuation of therapy in 3\u2005patients) and 6\/11\u2005patients had a progression. In the M\/A group, there were remissions in 9\/11\u2005patients (complete remissions after discontinuation of therapy in 3\u2005patients) and progression in 1\/11\u2005patients. There were more relapses in M\/A therapy after remission than in D\/C therapy. Side effects were more common in the M\/A group. These differences were not significant (p\u2003&gt;\u20030,05).<\/jats:p><jats:p> <jats:italic>Conclusion:<\/jats:italic> Because of the high number of progressions in patients treated with D\/C therapy, we can not confirm the encouraging results of earlier reports about pulse D\/C therapy. Nevertheless D\/C therapy seemed to be better tolerated and, in case of primary efficacy, was associated with fewer recurrences than M\/A therapy.<\/jats:p>","DOI":"10.1111\/j.1610-0378.2005.04747.x","type":"journal-article","created":{"date-parts":[[2005,2,16]],"date-time":"2005-02-16T18:23:52Z","timestamp":1108578232000},"page":"200-206","source":"Crossref","is-referenced-by-count":47,"title":["Intravenous dexamethasone\u2010cyclophosphamide pulse therapy in comparison with oral methylprednisolone\u2010azathioprine therapy in patients with pemphigus: Results of a multicenter prospectively randomized study"],"prefix":"10.1111","volume":"3","author":[{"given":"Ellen","family":"Rose","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Wever","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Detlef","family":"Zillikens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruthild","family":"Linse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uwe\u2010Frithjof","family":"Haustein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva\u2010Bettina","family":"Br\u00f6cker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,2,16]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(99)70183-0"},{"key":"e_1_2_7_3_2","unstructured":"LeverWF. Pemphigus and Pemphigoid Charles C Thomas Publisher Springfield 1965."},{"key":"e_1_2_7_4_2","doi-asserted-by":"crossref","unstructured":"ZillikensD DiazLA. Autoimmune bullous diseases. In: Burg G Dummer R: Strategies for immunointervention in dermatology. Berlin Heidelberg New York: Springer 1997; 217\u200a\u2013\u200a226.","DOI":"10.1007\/978-3-642-60752-3_19"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1996.03890260105016"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.135.1.76"},{"key":"e_1_2_7_7_2","doi-asserted-by":"crossref","unstructured":"Pandya Sontheimer RD. Treatment of pemphigus vulgaris with pulse intravenous cyclophosphamide. Arch Dermatol 1992; 128: 1626\u200a\u2013\u200a1630.","DOI":"10.1001\/archderm.128.12.1626"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.135.1.57"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1988.tb07104.x"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1990.tb04767.x"},{"key":"e_1_2_7_11_2","first-page":"143","article-title":"Dexamethasone\u2010cyclophosphamide pulse therapy in bullous autoimmune dermatoses","volume":"44","author":"Appelhans M","year":"1993","journal-title":"Hautarzt"},{"key":"e_1_2_7_12_2","first-page":"268","article-title":"Current therapy of pemphigus vulgaris","volume":"68","author":"Fellner MJ","year":"2001","journal-title":"The Mount Sinai Journal of Medicine"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.132.12.1435"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2003.05665.x"},{"key":"e_1_2_7_15_2","doi-asserted-by":"crossref","unstructured":"Mimouni D Nousari CH Cummins DL Kouba DJ David M Anhalt GJ. Differences and similarities among expert opinions on the diagnosis and treatment of pemphigus vulgaris. 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