Comparative study of pulse therapy with daily immunosuppressive therapy in steroid responsive dermatosis

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.

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.

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.

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.

DCP therapy is safe and effective in the treatment of steroid responsive dermatosis. Incidence of adverse effects was less with DCP Therapy.