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. 70, Num. 4, 2004, pp. 248-249

Indian Journal of Dermatology, Venereology, Leprology, Vol. 70, No. 4, July-August, 2004, pp. 248-249

Letter To Editor

Response by Dr. Ramam

Ramam M

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi - 110029
Correspondence Address:Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi - 110 029 mramam@hotmail.com

Code Number: dv04085

Sir,

The suggestions made by Gandhi et al will have to be considered by centers administering pulse therapy and implemented if considered beneficial and feasible. It would be ideal to compare the proposed changes to the original schedule in a randomised, controlled trial. Carefully kept records will be needed to document the time to remission, the duration of remission with treatment and the relapse-free period after stopping therapy: outcomes of importance to patients and dermatologists alike. I would like to make a comment on the utility of immunofluorescence testing in determining the length of treatment. There are few situations where indirect immunofluorescence (IIF) testing is of any significant diagnostic value in pemphigus. Its role in predicting prognosis is also limited. Direct immunofluorescence (DIF) testing fares better in predicting relapse-free remissions but is not reliable enough to be useful in everyday clinical practice.[1],[2] ELISA for antibodies to desmoglein 3 and desmoglein 1 is a relatively new test and time will tell if it will have much application in prognosis though this appears unlikely from previous experience with IIF. For the present, it appears that we will have to continue our search for reliable predictors of the response to treatment.

REFERENCES

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