Abstract

COMPARATIVE STUDY OF PULSE THERAPY WITH DAILY IMMUNOSUPPRESSIVE THERAPY IN STEROID RESPONSIVE DERMATOSIS

Background: Pemphigus, scleroderma and SLE are diseases of unknown etiology for which no specific treatment is effective. The introduction of corticosteroids and immunosuppressive drugs reduced the mortality rate. Objectives: To correlate signs and symptoms and incidence of adverse effects in patients with steroid responsive dermatosis before and during DCP therapy and daily immunosuppressive therapy. Material and Methods: 100 patients were enrolled in this study. They are divided into 2 groups. The treatment schedule in group 1 consists of giving 100mg dexamethasone on 3 consecutive days and 500 mg cyclophosphamide on day two and repeating these pulses (DCPS) every 4 weeks. In between the DCPS, the patient received only 50mg cyclophosphamide orally daily and generally no corticosteroids. Group 2 patients received daily immunosuppressive therapy in the form of tab prednisolone 1-2mg/kg body weight and tab cyclophosphamide 50 mg after food daily for 6months. Results: At the end of 6 months of study period, based on clinical improvement, good response was seen in 82% in group 1 and in 64% in group 2P<0.05 which is significant. Moderate response was seen in 10% in group 1 and in 22% in groups 2.8% in group 1 and 14% in groups 2 recorded poor responses. Better response was seen with DCP therapy. The incidence of adverse effects was less with DCP therapy when compared to daily immunosuppressive therapy. P<0.0001 which is highly significant. Conclusion: DCP therapy is safe and effective in the treatment of steroid responsive dermatosis. Incidence of adverse effects was less with DCP Therapy.

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