High-dose oral corticosteroids are the mainstay in pemphigus treatment. Doses often are increased until remission begins, at which point the amount of steroid gradually is tapered. Adverse reactions associated with prolonged high-dose steroid therapy must be monitored and managed.
People with severe disease that cannot be controlled with corticosteroids or who cannot tolerate high-dose therapy usually are prescribed a combination of immunosuppressive drugs (drugs that suppress the immune system) that help control the disease with the least amount of oral steroids.
Once cleared, pemphigus can recur; however, there can be long remissions and even cures.