Non Comparative Study on Various Pulse Regimens (DCP, DAP and DMP) in Pemphigus: Our Experience.
BACKGROUND
Pemphigus has been treated with Dexamethasone Cyclophosphamide Pulse (DCP) Therapy since 1981. Various modifications have been suggested in the original regimen. These include Dexamethasone Azathioprine Pulse (DAP) and Dexamethasone Methotrexate Pulse (DMP) therapies.


OBJECTIVE
To report our experience on the noncomparative study of various Pulse regimens DCP, DAP AND DMP therapies in patients with Pemphigus.


METHODS
The patients were put on three regimens depending upon the situation-Conventional DCP, DAP in the reproductive age group, DMP in patients who showed prolonged Phase I more than 12 months while on DCP.


RESULTS
30 patients were put on DCP therapy. The duration of phase I was on an average six months. Relapse was seen in 3 patients in phase IV. 12 patients on DAP therapy were considered. In Phase III 5 patients relapsed in phase IV four patients relapsed. Five patients were put on the DMP. Disease activity was poorly controlled and in three DMP was discontinued.


CONCLUSIONS
DCP remains the most effective regimen with quickest onset of remission and continuance of remission. In DAP therapy fixation of dose of azathioprine at 50 mgs daily may be counterproductive. DMP does not fulfil the promise of a viable treatment option in recalcitrant pemphigus and this lacunae needs to be plugged.
Department of Dermatology, STD and Leprosy, Government Medical College Srinagar, Kashmir, India.
Iffat
I
Hassan
JLNM Hospital, Directorate Health Services Rainawari, Kashmir, India.
Farah
F
Sameem
Department of Dermatology, STD and Leprosy, Government Medical College Srinagar, Kashmir, India.
Qazi Manaan
QM
Masood
Department of Dermatology, STD and Leprosy, Government Medical College Srinagar, Kashmir, India.
Imran
I
Majid
Department of Dermatology, STD and Leprosy, Government Medical College Srinagar, Kashmir, India.
Zubair
Z
Abdullah
Department of Dermatology, STD and Leprosy, Government Medical College Srinagar, Kashmir, India.
Qazi Masood
QM
Ahmad
Pemphigus; pulse therapy; relapse