A preliminary study on clinical outcome of corticosteroid therapy in pemphigus patients

Abstract

Introduction: Pemphigus is life threating blistering of autoimmune disease of the skin and mucous membrane characterised by autoantibodies (auto ABs) against desmoglein-3 (DSG-3). Desmosomal adhesions, protein expressed on the surface of epidermal keratinocytes. Aim: The present study was to assess the incidence rate of pemphigus, to evaluate the clinical course along with clinical manifestations, Complications and Metabolic factors of patients with pemphigus and to investigate the disease severity and induction of remission during the clinical course and whereas to assess the oxidative stress and antioxidant status in pemphigus patients in our hospital. Material and Methods: A prospective study was conducted over a period of January 2012 to December 2012 at dermatology department, MGM Hospital, Warangal. The data was collected from 32 cases of Pemphigus on the basis of Age, Sex, Social Habits, BMI, Histopathological forms, Clinical manifestations and Drug therapy. This hospital is 1200 bedded government hospital provided Outpatient and Inpatient care for Indian citizen especially in Telangana region free of cost. Results: Of the 32 pemphigus patients, 75% were diagnosed with Pemphigus Vulgaris (PV), 12.5% with Pemphigus Foliaceus (PF) and 12.5% with Bullous Pemphigoid (BP). The male to female ratio was approximately 1:1.3. The mean age of onset was 40.8 years in Pemphigus patients. The Onset of disease was 29.85. 34% of patients with Pemphigus had both the mucosal and skin involvement during the clinical course while 25% at the onset of disease. The most common complication was found to be increase blood sugar (40%). Most commonly prescribed adjuvant is dapsone. Majority attained the complete remission and remaining of them attains partial remission. Oxidative stress levels were higher and antioxidant status levels were lower in study subjects when compared to controls. Conclusions: PV is the most common subtype of Pemphigus in our Hospital and usually affects females more than males. Our study reveals that mucosal and skin involvement is common. Corticosteroids and dapsone as adjuvant is majorly prescribed. Most of patients attain complete remission and remaining of them achieves partial remission. Oxidative stress levels were higher and antioxidant status levels were lower in our study subjects when compared to controls.

Keywords

• Clinical course
• Pemphigus
• Remission
• Treatment