CYP3A4 and pemphigus: Has been reported to both exacerbate (75, 76) pemphigus as well as trigger it de novo (77).It has been suggested that rifampin contributes to flares of existing pemphigus by altering the metabolism of prednisone and other glucocorticoids, for example by induction of CYP3A4 leading to a decline of 30-60% of those drugs’ area under concentration-time curve. Has also been shown to interact with metabolism of mycophenolate by altering glucuronidation (75).