Objective To induce permanent remission in bullous pemphigoid patients Methods 5 patients of bullous pemphigoid treated with dexamethasone-cyclophosphamide pulse [DCP] therapy are being reported.
Diagnosis was confirmed by histopathology and immunofluorescence test. Each pulse comprised of dexamethasone 100 mg dissolved in 500 ml of glucose and transfused intravenously over 1-1.5 hours on three consecutive days. On 2nd day cyclophosphamide 500 mg was transfused through the same drip. It was repeated every 28 days. In between oral cyclophosphamide 50mg daily was given. The whole treatment was divided into 4 phases: phase I, till all the lesions cleared; phase II, no lesions but still DCP was given for 9 months; phase III DCP withdrawn, only oral cyclophosphamide 50mg daily was given for 9 months; and in phase IV, all the treatment was withdrawn and patients are followed-up as much as possible. Period of remission was noted
Results Out of five, three patients entered into remission up to 7.5 years after stoppage of all treatment. Remaining two are in remission for one to two years Conclusion Dexamethasone-cyclophosphamide pulse therapy is able to induce permanent remission in bullous pemphigoid