الفهرس 
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Abstract
This study included 30 patients with pemphigus vulgaris. The patients of this study were diagnosed through clinical criteria and biopsy specimens. Then the patients were classified into two equal groups:(Group I) included 15 patients treated with pulse therapy of intravenous methylprednisolone (1gm per dose on each of 3-5 consecutive days (pulse cycle)and Group II: included 15 patients treated with oral prednisolone 120-140 mg daily in 3 divided doses for 4-8 weeks.
The endpoint of the initial high-dose treatment will be reached when patients considered clinically as grade 1.Then the prednisolone dose will be tapered to 40 mg daily in 3 divided doses, until grade (0) is reached.The patients were followed up by clinical evaluation and laboratory evaluation of apoptosis, FasL detection, CD4 &CD8 and natural killer cells.Laboratory evaluation was performed before, one, two, three and six months after the start of steroids therapy. The mean time required for healing was significantly shorter (4.93 + 0.5 weeks) in group I than in group II(9.73 + 0.46 weeks). However, the total corticosteroid dose (counted in prednisolone equivalents) until complete healing (grade 0) was significantly higher in group I. In group I there were no significant changes in blood pressure and heart rates of patients during the IV infusion of methyl-prednisolone. The delayed side effects in group II were significantly higher than in group I, regarding hyperglycemia, hypertension and moon face Regarding the mean value of the pretreatment grading of neutrophil apoptosis, there was no significant difference between the 2 groups. While one month after the start of treatment, the mean value of the neutrophil apoptosis grading was significantly higher in group I than in group II. However, this value showed no significant difference between both groups at 2, 3 and 6 months after the start of treatment.It was found that the mean value of FasL expression in patients’ serum of both groups was decreased by treatment. This decrease showed a statistical significance when compared with the pre-treatment value after one month in group I and after two months in group II (P< 0.05). However, the mean value of FasL expression in both groups showed a statistically significant difference only at one month after the start of treatment. As regards the mean value of CD8, there was no any statistically significant difference between groups I and II before treatment and at all dates of follow up after the start of treatment.The pretreatment mean value of natural killer (NK) cells showed no significant difference between both groups. Also, this value showed no significant difference between both groups at 2 and 3 months after the start of treatment. However, the mean value of NK cells was significantly higher in group II than in group I, at one and 6 months after the start of treatment