Dexamethasone-cyclophosphamide pulse therapy in systemic lupus erythematosus.

BACKGROUND AND AIMS: Therapy systemic lupus erythematosus (SLE) has been generally discouraging. Methyl-prednisolone pulse therapy has been used for various connective tissue disorders. We used intravenous dexamethasone cyclophosphamide pulse therapy to treat SLE. METHODS: Fourteen patients (10 females and 4 males) between the age of 15-48 years with definite or classical clinical criteria laid by American Rheumatism Association criteria were treated by Dexamethasone-Cyclophosphamide pulse (DCP) therapy at our center. RESULTS: It was possible to induce a complete clinical remission with DCP therapy in most of the patients thereby offering them life free from disease and drugs. The side effects commonly observed with conventional daily dose regimen of corticosteroids were not present or were mild. CONCLUSIONS: Almost all patients had good response after 3-4 pulses to allow them a normal life style. Fever, malar rash and oral ulceration responded early but photosensitivity, discoid rash, alopecia and joint pains took some more time.

Ectrodactyly.

A rare case of ectrodactyly or lobster claw without any other ectodermal involvement is presented. His family history was non-contributory.

Chemical peeling--glycolic acid versus trichloroacetic acid in melasma.

Melasma continues to be a therapeutic challenge. 100 patients of melasma not responding to conventional depigmenting agents were divided into 2 groups, one treated with 55-75% glycolic acid (68 patients) and the other with 10-15% trichloroacetic acid (32 patients). Applications were made after every 15 days and response assessed clinically along with relapse or hyperpigmentation after 3 month follow up period. More than 75% improvement was seen in 30%, and 50-75% improvement in 24% patients. Response with TCA was more rapid as compared to GA. Chronic pigmentation responded more favourably to TCA. Relapse and hyperpigmentation was more-25% in TCA as compared to 5.9% GA. Sun exposure was the most important precipitating factor followed by pregnancy and drugs.

A clinico-epidemiological study of leprosy in arid north-west Rajasthan, Jodhpur.

A detailed clinical, bacteriological and histopathological study of 1373 patients of leprosy who sought medical advice at the Department of Skin, STD and Leprosy of Dr. Sampurnanand Medical College, Jodhpur, during 1975-1993 is reported. The disease was observed in 1.54 patients per 1000 cases attending in the skin department out-patients. More than 50% of them had polar type of lepromatous leprosy. The disease was found 2.42 times more often in males than in females and was found mainly in the age group 11-70 years. Family history of leprosy was obtained in 130 (9.5%) of the cases. Lepra reactions were seen in 151 (11%) cases, of which 30 had type 1 reaction (19.2%) and 121 type 2 reaction (80.1%). The majority of leprosy cases (966 or 70.4%) were from Jodhpur district, followed by 109 (7.9%) from Nagaur district and then from, Barmer, Jaisalmer and Jalore etc. All cases of leprosy responded well to the WHO regimens of multidrug therapy. The reactional cases were satisfactorily managed with higher doses of clofazimine along with oral prednisolone.