Further Studies on Pemphigus Patients Treated with Dexamethasone

Abstract

Our regime for the treatment of pemphigus consists of 100mg dexamethasone dissolved in 5% glucose given by a slow intravenous drip over 1-2 hours and repeated on 3 consecutive days. On the first day, 500 mg cyclophosphamide is also given in the same drip. Such dexamethasone cyclophosphamide pulses (DCP) are repeated once a month. In between the (DCP), the patient is given only 50 mg cyclophosphamide daily orally. During the first few methods of starting this treatment, most patients continue to get relapses of pemphigus lesions in between the DCP (phase I). After a variable period however, almost all patients stop having such relapses, but we continue to give once monthly DCP for atleast 6 months (phase II), After which the DCP is stopped and the patient continues to take 50 mg cyclophosphamide daily orally for a further period of one year (phase III). At the end of thos phase all treatment is stopped and the patients followed-up for any relapse (phase IV). Follow up of the first 100 patients, pemphigus vulgaris (92), pemphigus follaccus (6) and pemphigus erythematosus (2), has