Pulse Therapy with Dexamethasone Cyclophospamide in Pemphigus

Abstract

In order to achieve better therapeutic results, 10 patients having pemphigus vulgaris were treated with repeated pulses of dexamethasone and cyclophosphamide. Each pulse consisted of 100 mg dexamethasone given intravenously in 5 % glucose over a period of 1 hour on three consecutive days. In addition, 500 mg cyclophosphamide was given with the pulse on the first day, followed by 50 mg orally daily even in between the pulses. Such pulses were repeated every 2-4 weeks depending upon the clinical activity of the disease. With this therapy, healing of skin lesions was generally much faster and the patient could as a rule be discharged within 4-5 days. Secondly, the side effects usually associated with prolonged corticosteriod therapy were far milder. In a follow-up varying from 13 ½ to 26 ½ months, 6 patients remained free from relapses for 6 to 14 ½ 2 months, while 4 patients continued to develop relapses at variable intervals sfter each pulse.