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LETTER TO EDITOR
Year : 1991  |  Volume : 57  |  Issue : 6  |  Page : 317

Comparison of dexamethasone and dexamethasone - cyclophosphamide pulse therapy in pemphigus

OP Singh
,

Correspondence Address:
O P Singh


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How to cite this article:
Singh O P. Comparison of dexamethasone and dexamethasone - cyclophosphamide pulse therapy in pemphigus. Indian J Dermatol Venereol Leprol 1991;57:317

How to cite this URL:
Singh O P. Comparison of dexamethasone and dexamethasone - cyclophosphamide pulse therapy in pemphigus. Indian J Dermatol Venereol Leprol [serial online] 1991 [cited 2013 May 25];57:317. Available from: http://www.ijdvl.com/text.asp?1991/57/6/317/3725


To the Editor,

Pemphigus, a potentially fatal blistering disease have been treated with a number of drugs and therapeutic regimens. [1] Corticoste­roids have been the mainstay of treatment. [2] Pulse therapy with dexamethasone-cyclo­phosphamide has been reported to be very effective in controlling the disease and keep­ing the patients in remission. [3] We compared two regimens using dexamethasone alone and dexamethasone-cyclophosphamide pulse to evaluate their efficacy, and to determine whether dexamethasone pulse alone is as effective as the combination of dexamethasone and cyclophosphamide pulse.

Three adult male patients of pemphigus vulgaris, confirmed by histopathology and im­munofluorescence test, were initially treated with dexamethasone pulse, consisting of 100 mg dexamethasone in 5% dextrose, given in­travenously over 1-2 hours on three consecu­tive days in a month. All the three patients use to have substantial healing of the lesions after the pulse but the fresh lesions use to appear after 10-15 days. Six month later all the three patients were put on adjuvant cy­clophosphamide along with dexamethasone. Cyclophosphamide was given as 500 mg in­travenously once a month on day two and 50 mg tablet orally daily. After two such pulses the remission in between the pulses became prolonged to 3-4 weeks and the severity of the disease also become less. Various im­mune-suppressive drugs in combination with corticosteroids have been used in the past with good results [4],[5],[6]

 Our observations conclude that the adju­vant therapy with cyclophosphamide is more effective than dexamethasone alone in con­trolling the morbidity and mortality in pemphigus.

 
  References Top

1.Pye RJ :Bullous eruptions in : Text Book of Der­matology, Fourth ed, Editors, Rook A, Wilkinson DS, Eoling FJG et al : Oxford University Press, Bombay, 1987; p 1619-1663.  Back to cited text no. 1    
2.Saviri JA : International mortality from bullous dis­eases since 1950, Brit J Dermatol, 1976; 94 :179­189.  Back to cited text no. 2    
3.Pasricha JS, Thanzama J and Khan UK: Intermit­tent high dose dexamethasone-cyclophosphamide therapy for pemphigus, Brit J Dermatol, 1988; 119 : 73-77.  Back to cited text no. 3    
4.Lever WF: Methotrexate and prednisolone in pemphigus, Arch Dermatol, 1972 ; 106 : 491-497­  Back to cited text no. 4    
5.Krain LS . Pemphigus, Arch Dermatol, 1974 ; 110 : 862-865.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]
6.Roenigk HH and Deodhar S : Pemphigus treatment with Azathiopnne, 1973 ; 107 : 353-357.  Back to cited text no. 6    




 
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