Safety of parenteral dexamethasone vs. oral prednisolone in the treatment of pemphigus vulgaris

To observe the safety of parenteral dexamethasone compared with oral prednisolone in the treatment of pemphigus vulgaris. A clinical trial was carried out in the department of Dermatology and Venereology, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total number of patients was thirty. Among them fifteen patients were treated with injection dexamethasone [group A] and other fifteen were treated with oral prednisolone [group B]. Statistically significant improvement was observed in both groups in all clinical parameters after 6 weeks. But dexamethasone group showed statistically more significant improvement than prednisolone group in all clinical parameters except Nikolsky's sign. Most common adverse effects in both groups were weight gain, increased appetite, puffy face and hyperglycemia. In dexamethasone group other side effect was sleep disturbance. In prednisolone group other side effects were gastritis, sleep disturbance, nausea and vomiting, herpes zoster infection, reactivation of tuberculosis and mood change. Parenteral dexamethasone appears to be safer than oral prednisolone in the management of pemphigus vulgaris with an acceptable efficacy profile

Cutaneous morphological patterns of adverse drug reactions: a study of 50 cases

Adverse drug reactions are common complications in drug therapy. About 3-8% of all hospital admissions are the results of adverse drug reactions, and these can cause significant disability to patients. To evaluate the clinical spectrum of all cutaneous adverse drug reactions and to establish the causal link between suspected drug and the reaction. This observational cross-sectional study was done among the patients having cutaneous drug eruptions. 50 consecutive patients were enrolled. Purposive sampling was done. In every patient a detailed history was taken. Examination was carried out to find out the type of cutaneous reactions. Data were collected in a predesigned structured questionnaire. Statistical analysis was done with the help of SPSS. Out of 50 respondents, 20% had a history of indigenous drug intake followed by 18% sulphonamides, 14% NSAIDs, 14% quinolones, 8% anticonvulsants, 8% cephalosporins, 6% penicillins, 4% antituberculous drugs, 4% metronidazole and 4% tetracyclines. 34% had maculopapular rash, 24% Stevens-Johnson syndrome, 12% exfoliative dermatitis, 10% urticaria, 8% fixed drug eruption, 8% erythema multiforme, 8% bullae, 6% vesicles, 2% lichenoid eruption and 2% scaly eruptions. Frequency distribution of the offending drugs and the adverse reactions revealed that cephradine was responsible for maculopapular rash, sulphonamides for Stevens-Johnson syndrome, indigenous medicines for exfoliative dermatitis, NSAIDs for urticaria and paracetamol for fixed drug eruption