A 45-year-old man has a 3-year history of a recurrent and painful blistering eruption affecting the oral mucosa and the flexural areas. Biopsy and direct immunofluorescence results were consistent with pemphigus vulgaris (PV).
Patient underwent the following treatment phases: phase 1 (control), high dosages of glucocorticosteriod to achieve initial control of the acute disease; phase 2 (consolidation), constant dosage until most lesions are healed and itching ceases; and phase 3 (maintenance), glucocorticosteroid dosage gradually tapered.
Presently, with the patient's substantial cumulative glucocorticosteroid dosage, he is worried with the complications associated with it such as: osteoporosis, adrenal suppression, cataracts, diabetes, and predisposition to infection.
He did an internet search and found articles regarding the use of dapsone in pemphigus vulgaris. He would like to know if this may be a good first-line steroid-sparing medication.