1. General support treatment
is extremely important. People with extensive damage should be given a high-protein diet and supplemented with multivitamins. Pay attention to the balance of water and electrolyte, and fasting should be supplemented by vein. Systemic failure can be repeated with small amounts of blood transfusion or plasma. Strengthen nursing, pay attention to skin cleanliness and hygiene, so as to reduce secondary infection of wound surface and prevent pressure sore.
2. Systemic treatment
(1) Glucocorticoid is the first choice for the treatment of this disease. Try to treat it in time, control the amount in full, reduce the amount correctly, and continue to use the minimum maintenance dose. In severe cases, shock therapy can be used. Nearly half of the patients who took glucocorticoids died of complications of glucocorticoids, such as respiratory tract infection, pulmonary embolism, diabetes and digestive tract ulcer. Therefore, we must always be alert to the occurrence of adverse reactions and take corresponding measures in time.
(2) Immunosuppressants can inhibit the formation of autoantibodies, which is the main adjuvant therapy for this disease. Combined with glucocorticoid, it can improve the curative effect and reduce the dosage of hormone. Commonly used are azathioprine and cyclophosphamide.
(3) After using glucocorticoid to control the disease, gold preparation can be added for treatment.
(4) Plasma exchange therapy is suitable for patients with serious illness, ineffective combined therapy with glucocorticoid and immunosuppressant, and high drop of pemphigus antibody in blood. When high-dose glucocorticoid therapy has side effects or the curative effect is not obvious, it can be selected. 1 or 2 times a week, 1 ~ 2L each time, 4~1 times continuously according to the illness. For example, it is best to use it with low-dose glucocorticoid or immunosuppressant.
(5) A few other cases are effectively treated with the following drugs, such as ampicillin, sulfadiazine, nicotinamide and tetracycline, alone or in combination with glucocorticoid. High-dose immunoglobulin can relieve pemphigus quickly, but the duration is short. Aviva combined with prednisone in the treatment of proliferative pemphigus.
3. Local treatment
Pay attention to oral hygiene and treat periodontal diseases. Oral erosion can be rinsed with 2% boric acid solution or 1% hydrogen peroxide every 3 ~ 4 hours. When the pain is obvious, you can apply 3% benzocaine borate glycerin solution or 1% procaine solution to gargle before eating. When the skin lesions are few, zinc oxide oil and 2% methyl violet zinc oxide oil are applied externally to the rotten noodles. Erythema damage can be externally applied with glucocorticoid cream. When the damage is extensive, pay attention to avoid the infection of conditional pathogenic bacteria. For example, if there are more scabs in exudate and the patient is generally in good condition, you can take a medicinal bath, such as 1: 1 potassium permanganate solution. Antibiotics and antifungal preparations for external use.