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Systemic corticosteroids have been a mainstay in pemphigus treatment for more than 50 years. Although these agents induce remission particularly well, prolonged administration of the high doses needed to suppress disease activity can lead to iatrogenic osteoporosis, diabetes, hypertension, cataracts, and infections. To avoid these effects, clinicians now commonly add immunosuppressive drugs that allow decreased doses of systemic steroids. Features of dapsone make it an ideal steroid-sparing agent: It is less expensive, less immunosuppressive, and better tolerated than many other immunomodulatory agents. Dapsone has been used adjunctively in pemphigus therapy for several years, but no controlled efficacy trials have previously been performed…