PEMPHIGUS
Essentials of Diagnosis
•
Bullous skin disorder of poor prognosis.
•
First lesion may occur in any part of the body.
•
There is an offensive, characteristic odour.
•
Later on, eruptions may become generalised along
with itching, loss of weight and anaemia.
•
Bullae arise from a normal skin with erythema around.
•
Bullae tends to be tense due to contained serum.
•
Rupture of bullae leaves a raw, exuding surface
which becomes crusted.
•
When crusts are shed, pigmentation remains for many
weeks/months.
Treatment
o
Hospitalise the patient.
o
High calorie, high protein diet.
o
1% aqueous Gentian violet is soothing and
reduces bacterial infection or dress with Sofratulle and Neosporin ointment.
o
Cap Ampicillin 250-500 mg 1 qid × 7 days to
overcome secondary infection or Cap Doxycycline 100 mg bd for 10-20 days.
o
Tab Prednisolone 120-150 mg in divided doses.
Reduce slowly to maintenance dose of 10-20 mg/ daily.
o
Betnovate-N ointment apply twice daily.
o
Betnesol-N eyedrops 6 hourly for 7 days at
least.
o
Cyclophosphamide + Methotrexate.
o
Cyclophosphamide 200 mg daily then reduced to 50
mg od Tab vit C 500 mg 1 bd for 20 days.
