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Suggest Treatment For Recurring Pemphigus Vulgaris

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Posted on Thu, 5 Feb 2015
Question: Dear sir I am suffered from pemphigus vulgaris from August and I got precaution from a specialist but p.v again occur what I do
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Answered by Dr. Kalpana Pathak (50 minutes later)
Brief Answer:
Pemphigus responds best to pulse therapy of steroids

Detailed Answer:
Hi,

Thanks for writing to us.

Pemphigus Vulgaris presents as a blistering disorder and involves the skin as well as oral cavity. It is a chronic autoimmune disorder and can never be cured. Our aim is to bring the patient under remission which could be for months, years or life long.

We treat a mild case of Pempghigus Vulgaris with oral steroids. However if the disease is recurrent, extensive and severe then the best option is to start dexamethasone cyclophosphamide pulse therapy. Here we admit a patient for three days and infusion of dexamethasone on all three days and cyclophosphmide on second day is given. The DCP therapy is divided in four phases where monthly cycles of DCP is continued along with oral cyclophosphamide till no blister or erosion forms. Once this is achieved we start second phase where fixed nine cycles of DCP are given along with oral daily cyclophosphamide. Once this is over we put the patient on oral daily dose of cyclophosphamide for another nine months. Finally last phase involves withdrawal of medicines and regular follow up of patient.

DCP therapy has revolutionised treatment of pemphigus vulgaris. Other treatment options are rituximab, mycophenolate mofetil, etc.

My advise to you would be to approach a dermatologist attached with some hospital or medical college for your skin disease as in pemphigus we need proper blood work, cardiac monitoring etc., during and after therapy which cannot be done in a normal OPD setup.

Hope this helped.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. Kalpana Pathak

Dermatologist

Practicing since :2006

Answered : 2014 Questions

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Suggest Treatment For Recurring Pemphigus Vulgaris

Brief Answer: Pemphigus responds best to pulse therapy of steroids Detailed Answer: Hi, Thanks for writing to us. Pemphigus Vulgaris presents as a blistering disorder and involves the skin as well as oral cavity. It is a chronic autoimmune disorder and can never be cured. Our aim is to bring the patient under remission which could be for months, years or life long. We treat a mild case of Pempghigus Vulgaris with oral steroids. However if the disease is recurrent, extensive and severe then the best option is to start dexamethasone cyclophosphamide pulse therapy. Here we admit a patient for three days and infusion of dexamethasone on all three days and cyclophosphmide on second day is given. The DCP therapy is divided in four phases where monthly cycles of DCP is continued along with oral cyclophosphamide till no blister or erosion forms. Once this is achieved we start second phase where fixed nine cycles of DCP are given along with oral daily cyclophosphamide. Once this is over we put the patient on oral daily dose of cyclophosphamide for another nine months. Finally last phase involves withdrawal of medicines and regular follow up of patient. DCP therapy has revolutionised treatment of pemphigus vulgaris. Other treatment options are rituximab, mycophenolate mofetil, etc. My advise to you would be to approach a dermatologist attached with some hospital or medical college for your skin disease as in pemphigus we need proper blood work, cardiac monitoring etc., during and after therapy which cannot be done in a normal OPD setup. Hope this helped.