Plica neuropathica: different etiologies in two cases.

Systemic corticosteroids are the treatment of choice for pemphigus vulgaris. Immunosuppressive agent (azathioprine, cyclophosphamide) could be added for patients with severe disease that cannot be controlled by corticosteroids alone or to reduce the dose of corticosteroids.[5] However, immunosuppressants continue to have the complications of systemic infections. Successful use of rituximab therapy has been reported in refractory childhood pemphigus vulgaris.[6] Some authors recommend use of intravenous immunoglobulins for cases of childhood and juvenile pemphigus, in which this therapy can delay the need for administration of immunosuppressive drugs.[7]