Safety of parenteral dexamethasone vs. oral prednisolone in the treatment of pemphigus vulgaris

Authors

  • Mohammad Jamal Uddin
  • AZM Maidul Islam
  • Mohammad Eakub Ali
  • Md Abdul Wahab
  • Lubna Khondker
  • Md Shirajul Islam Khan

Keywords:

Safety, parenteral dexamethasone, treatment, pemphigus vulgaris

Abstract

Objective To observe the safety of parenteral dexamethasone compared with oral prednisolone in the treatment of pemphigus vulgaris. Patients and methods A clinical trial was carried out in the department of Dermatology and Venereology, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total number of patients was thirty. Among them fifteen patients were treated with injection dexamethasone (group A) and other fifteen were treated with oral prednisolone (group B). Results Statistically significant improvement was observed in both groups in all clinical parameters after 6 weeks. But dexamethasone group showed statistically more significant improvement than prednisolone group in all clinical parameters except Nikolsky’s sign. Most common adverse effects in both groups were weight gain, increased appetite, puffy face and hyperglycemia. In dexamethasone group other side effect was sleep disturbance. In prednisolone group other side effects were gastritis, sleep disturbance, nausea and vomiting, herpes zoster infection, reactivation of tuberculosis and mood change. Conclusion Parenteral dexamethasone appears to be safer than oral prednisolone in the management of pemphigus vulgaris with an acceptable efficacy profile. 

References

Scully C, Challacombe SJ. Pemphigus vulgaris: update on etiopathogenesis, oral manifestation and management. Crit Rev Oral Biol Med. 2002;13:397-408

Herbst A, Bystryn JC. Pattern of remission in pemphigus vulgaris. J Am Acad Dermatol. 2000;42:422-7.

Stanley JR. Autoimmune blistering dermatoses. In: Wolff K, Goldsmith LA, Katz SI et al, editors. Fitzpatrick’s Dermatology in General Medicine, 6th edn. New York: McGraw-Hill; 2008. P.558-67.

Stephen E. Systemic corticosteroid. In: Wolverton SE, editor. Comprehensive Dermatologic Drug Therapy, 2nd edn. Philadelphia: WB Saunders; 2001. P.109-46.

Victoria PW. Systemic corticosteroids. In: Wolff K, Goldsmith LA, Katz SI et al, editors. Fitzpatrick’s Dermatology in General Medicine, 6th edn. New York: McGraw-Hill; 2008. P. 2381-8.

Sehgal VN. Pemphigus in India: A note. Indian J Dermatol. 1972;18:5-7.

Toth GG, an de Meer JB, Jonkman MF. Dexamethasone pulse therapy in pemphigus. J Eur Acad Dermatol Venereol. 2002;16:562-3.

Kanwar AJ, Kaur S, Thami GP. Long term efficacy of dexamethasone-cyclophosphamide pulse therapy in pemphigus. Dermatology. 2002;204:228-31.

Engineer L, Bhol KC, Ahmed AR. Analysis of current data on the use of intravenous immunoglobulins in management of pemphigus vulgaris. J Am Acad Dermatol. 2000;43:1049-57.

Carson P, Hameed A, Ahmed AR. Influence of treatment on the clinical course of pemphigus vulgaris. J Am Acad Dermatol. 1996;34:645-52.

Harman S, Albert, Black MM. Guidelines for management of pemphigus vulgaris. Br J Dermatol. 2003;149:926-37.

Bystryn J, Steinman N. The adjuvant therapy of pemphigus; an update. Arch Dermatol. 1996;132:203-12.

Downloads

Published

2016-12-15

How to Cite

1.
Uddin MJ, Islam AM, Ali ME, Wahab MA, Khondker L, Khan MSI. Safety of parenteral dexamethasone vs. oral prednisolone in the treatment of pemphigus vulgaris. J Pak Assoc Dermatol [Internet]. 2016Dec.15 [cited 2024Jul.13];23(2):163-7. Available from: http://www.jpad.com.pk/index.php/jpad/article/view/301

Issue

Section

Original Articles

Most read articles by the same author(s)

1 2 3 > >>