Tulasi Jarang1, Kavitha S. B2, Narsimha Rao Netha Gurram3
Pemphigus is a group of autoimmune disease that affect skin and mucous membranes clinically manifested by flaccid blisters because of acantholysis. Pulse therapy was initiated in 1981 to treat the cases of pemphigus, which has reduced the mortality to a great extent. Various regimens of pulse therapy Dexamethasone-Cyclophosphamide (DCP), Dexamethasone-Azathioprine (DAP), Dexamethasone-Methotrexate (DMP) and Dexamethasone only are used. The aim of the study is to study the efficacy and various side effects associated with pulse therapy.
MATERIALS AND METHODS
Patients were put on DCP, DAP and DOP are used depending on the age and completion of family.
194 patients were started on pulse therapy. 63 males, 131 females (M:F-1:2). Age ranged from 9 years to 68 years. Majority of the patients were in the age group of 31-40 years (29.4%). 184 cases were diagnosed as Pemphigus Vulgaris (PV), 1 case as pemphigus vegetans (P veg) and 9 cases as Pemphigus Foliaceus (PF). DCP was started in 147 cases, DAP in 38 cases and DOP in 9 patients. Out of 194 patients, 137 (70.6%) patients were on regular treatment, 12 (6%) were irregular, 38 (19.5%) were defaulted and 7 (3.6%) patients were died. Relapse was seen in 3 patients in phase II, 5 patients in phase III, 4 patients in phase IV and 5 patients after pulse therapy.
Though side effects are more with DCP, it is most effective in reducing the morbidity, mortality and relapses as compared to DAP and DOP.