Pemphigus vulgaris:: benefits of tetracycline as adjuvant therapy in a series of thirteen patients

Background Tetracycline is an antibiotic which has been proven beneficial as an immunomodulating drug in the treatment of autoimmune bullous diseases. Methods Thirteen hospitalized patients with pempigus vulgaris received tetracycline 2 g/day for 1 month, then 1 g/day for the following 4 weeks. Prednisone 0.5-1 mg/kg/day was then gradually reduced. The control group consisted of seven patients with pemphigus who had received prednisone and azathioprine. Results A total of 13 patients in the study group achieved cessation of new blister formation within 5.4 days, compared to 23.71 days (p < 0.0001). The average initial dose of prednisone was 76.53 mg/day for the study group and 118.57 mg/day in the control group (p < 0.014). The average number of days before reduction of the prednisone dosage could begin was 16.53 days for the study group compared to 31.28 days in the control (p < 0.049). Total hospitalization time was also significantly lower: 34.07 days (p < 0.001). The clinical response was not linked to the location of lesions nor to severity of disease. Conclusions Tetracycline was shown to be effective as an adjuvant therapy for pemphigus with low toxicity and safety.