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Indian Journal of Dermatology, Venereology and Leprology
Medknow Publications on behalf of The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL)
ISSN: 0378-6323 EISSN: 0973-3922
Vol. 69, Num. 4, 2003, pp. 314-315
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Indian Journal of Dermatology, Venereology & Leprology, Vol. 69, No.
4, July-August, 2003, pp. 314-315
Letter to the Editor
Response by the author
C. Balachandran
Department of Skin & STD, Kasturba Medical College,
Manipal - 576119
Correspondence Address:
Department of Skin & STD, Kasturba Medical College, Manipal - 576119
Office.kmc@manipal.edu
Code Number: dv03047
I appreciate the keen interest shown by Dr. Ramji Gupta in our article 'Treatment
of pemphigus'.
- I agree that there are only 25 references. Reference number 4 in the
text should be 3, reference number 5 should be 4 and so on. I regret this
error.
- Regarding the second question, I have not made any such comment in
the text.
I would like to mention that the current dexamethasone-cyclophosphamide
pulse regimen is not final and needs modifications. There are now various
centers in
India using it, but there is no uniformity. With our vast experience in pulse
therapy, we should evolve a modified uniform regimen.
- It is better to give a slow infusion for 3-4 hours, as there is a risk
of cardiac toxicity with rapid steroid infusion.
- We have been following this regimen for many years now. We have had
two deaths due to septicemia in phase 1 in spite of the patient being on
antibiotics. Hence,
infection is an important complication that should be appropriately treated.
The majority of patients respond within 4 pulses in the first stage and require
about 6 pulses in the second stage. We also had patients who required
about 24
pulses for remission. A few patients also had relapsed during the third phase.
But overall this is an acceptable treatment modality.
- I did not add many Indian references regarding pulse therapy as there
were no new messages to convey.
Copyright 2003 - Indian Journal of Dermatology, Venereology & Leprology.
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