Hietanen J, Salo OP.
DOI: 10.2340/0001555562491496

Between 1969 and 1978, 44 pemphigus (p.) patients were treated in Finnish hospitals. The number of new cases was 36, giving an annual incidence of 0.76 cases per million inhabitants. The male/female ratio was 0.9:1. Nine patients had p. vulgaris (p.vu.); one p. vegetans (p.ve.); 9, p. foliaceus (p.fo.); 22, p. erythematodes (p.er.); and 3, p.NUD (p.NUD). One patient with p.er. also had myasthenia gravis. The mean age at onset was 57 1/2 years. The disease started in the mouth only in p.vu. (78% of cases) and in p.NUD (67%). Prednisone (or its derivatives) was most commonly used for systemic treatment, the mean initial dose being 61.4 mg/day. P.vu. and p.NUD required higher initial doses of prednisone and a longer duration of the high-dose treatment. The smallest mean daily dose of prednisone required to achieve a remission of at least 6 months was 5.2 mg. The mean duration of remission was 30 1/2 months. The frequency of side effects of systemic drug therapy was low (18%), possibly because only comparatively low doses of prednisone were used in Finland. The cause of death in 3 (6.8%) out of 44 patients was attributable either to p. itself or to its treatment. The mean annual number of hospitalization days for the whole material was 16.4 days and the mean annual number of hospital admissions 0.7.