What is the primary treatment for pemphigus vulgaris?

The primary treatment for pemphigus vulgaris is systemic corticosteroids (prednisone) to suppress the autoimmune response and halt blister formation. In severe or steroid-resistant cases, steroid-sparing immunosuppressants (azathioprine, mycophenolate mofetil, cyclophosphamide) are added. Rituximab (anti-CD20 monoclonal antibody) has emerged as an effective treatment for refractory PV. Topical steroids alone are insufficient. Antibiotics, antifungals, and antivirals treat secondary infections but do not address the underlying autoimmune pathology.