Dexamethasone-cyclophosphamide pulse therapy in systemic lupus erythematosus

Dhabhai, Ravindra; Kalla, G; Singhi, M. K.; Ghiya, Bhikam Chand; Kachhawa, Dilip

doi:10.4103/0378-6323.13778

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…Dhabhai et al .,[2] in an Indian study reported significant improvement in Quality of Life (QOL) of systemic lupus erythematosus (SLE) patients only after three to four pulses. Methylprednisolone pulses were routinely given in SLE by physicians, but are expensive in Indian context.…”

Section: Introductionmentioning

confidence: 99%

Dexamethasone- cyclophosphamide pulse in collagen vascular diseases: An observation

Das

Giri

Roy

2011

Indian Dermatol Online J

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Background:Treatment of collagen vascular diseases like systemic sclerosis, dermatomyositis, systemic lupus erythematosus (SLE) and even overlap syndromes has been difficult since long. Monumental success of dexamethasone-cyclophosphamide pulse (DCP) in pemphigus has prompted many a dermatologist to try it in other autoimmune diseases.Materials and Methods:DCP was given as per standard regimen for six to nine pulses. Immunosuppressives were given for 12–18 months in dermatomyositis, SLE, and overlap syndrome, and for 12 months in systemic sclerosis. Daily dose of steroid was tapered off gradually.Results:The treatment resulted in 90% improvement in skin binding in systemic sclerosis, 80% in exertional dyspnea, 40% in dysphagia, but minimum improvement was seen in Raynauds and digital tip ulcerations. No improvement in pigmentation was noted. In SLE, malar rash cleared in 70%, joint pain in 80%, oral ulcerations reduced in 80%, fever in 98%, and photosensitivity improved in one-third of patients. In dermatomyositis, improvement in muscle tenderness was seen in 100%, improvement in proximal myopathy and heliotrope rash in 80%, and improvement of shawl sign was observed in 80% of the patients. Some flattening of Gottron papules and plaques was noted in some patients. Both overlap patients improved significantly. Out of 24 patients, three were lost to follow-up, one resorted to homeopathic medicine and two expired (one dermatomyositis, one SLE). Side effects like hypertension, hyperglycemia, pyoderma, fungal infections, obesity, psychosis, etc. were seen in 25–30% of patients.Conclusions:We conclude that DCP is relatively safe, effective as well as cheap compared to methylprednisolone pulse. Side effects are also less compared to daily regimen of steroids. We also observed that patients who reported early and put on pulse early responded better.

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Section: Introductionmentioning

confidence: 99%

Dexamethasone- cyclophosphamide pulse in collagen vascular diseases: An observation

Das

Giri

Roy

2011

Indian Dermatol Online J

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“…In neonates and young children, infection is usually acquired from their parents. [ 3 ] It is speculated that impaired or immature barrier function of skin of neonates, especially in preterm infants, plays an important role in acquiring dermatophyte infections during initial maternal-infant skin-to-skin contact. Furthermore, spread of dermatophytes during this very early period of life can also be assisted by immature microbiome and suboptimal immune responses.…”

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confidence: 99%

“…Among the few cases reported among neonates in the past and in a recent review of the literature of neonatal and early infantile dermatophytoses [ Table 1 ],[ 5 ] the most common organism cultured was Trichophyton rubrum . [ 2 , 3 , 5 , 6 - 8 ] Some risk factors that contribute to acquiring dermatophytosis in neonates include an active dermatophytic infection in close contacts, humid environment, epidermal immaturity, and immunosuppression. The immune system of neonates is relatively suppressed compared to that of adults.…”

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confidence: 99%