ppt kulit gina.pptx

8/19/2019 ppt kulit gina.pptx

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JOURNAL READINGSAFETY OF PARENTERAL DEXAMETHASONE VS. ORAL

PREDNISOLONE IN THE TREATMENT OF PEMPHIGUS VULGARIS

Pembimbing : Dr. Eko ri!n"n#o$ S%

O&e' :

Regin" Fri!#"!"ri

()(.(*.+,+


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INTRODUCTION

Pemphigus vulgaris (PV) is the most common type of pemphigus

and comprises about 80% of patients with pemphigus. About 0.8%

of all dermatologic patients suffer from pemphigus


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he prevalence of pemphigus vulgaris is almost e!ual in men

and women. he mean age of onset is fourth to si"th decades.#

here is strong genetic bac$ground to pemphigus vulgaris and

there is also &A association in pemphigus vulgaris. 'ost patients

are of &A phenotype * or +.,


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-n about 0/0% of the cases the disease begins with oral

lesions1 which may precede the cutaneous lesions by several

months. 2utaneous lesions arelocali3ed or generali3ed and usually

present primarily as flaccid vesicles or bullae varying in si3e from

less than 4 cm to several cm.


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he scalp1 presternal1 genitals1 a"illae and groin are fre!uent

sites of involvement. he blisters rupture easily and produce

painful raw denuded areas. he 5i$ols$y6s sign is present.


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e"amethasone is a long/acting synthetic steroid. he

glucocorticoid effect in per mg is about +. times stronger than

prednisolone. Prednisolone is an intermediate acting synthetic

corticosteroid


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oday the ris$ of death in pemphigus from the side effect of oral

prednisolone is greater than ris$ of death from the disease itself.

eath from sepsis and other complications of therapy occurs in

% to 40% of treated cases. 7ntreated disease is usually fatal.


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here is scanty data regarding the use of parenteral

de"amethasone in pemphigus in angladesh. his study was

underta$en to see the safety level of parenteral de"amethasone

compared with prednisolone in early management of pemphigus

vulgaris.


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PATIENTS AND METHODS

his clinical trial was carried out in the department of

dermatology and venereology1 angabandu 9hei$h 'u:ib 'edical

7niversity1 ha$a1 from ;anuary ,040 to ;une ,044. hirty patients

of pemphigus were enrolled< 4 patients were treated with in:ection

de"amethasone (group/A) and other 4 were treated with oral

prednisolone (group )


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T AB L E 1 S H O W E D T H A T A L L D E M O G R A P H I C ,

C L I N I C A L PA R A M E T E R W E R E A L M O S T I D E N T I C A L I NT W O G R O U P S ( P > 0 . 0 5 ) .


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RESULTS

9tatistically significant improvement was observed in both groups in all

clinical parameters after + wee$s. ut de"amethasone group showed statistically

more significant improvement than prednisolone group in all clinical parameters

e"cept 5i$ols$y6s sign. 'ost common adverse effects in both groups were

weight gain1 increased appetite1 puffy face and hyperglycemia. -n de"amethasone

group other side effect was sleep disturbance. -n prednisolone group other side

effects were gastritis1 sleep disturbance1 nausea and vomiting1 herpes 3oster

infection1 reactivation of tuberculosis and mood change.


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CONCLUSION

Parenteral de"amethasone appears to be safer than oral

prednisolone in the management of pemphigus vulgaris with an

acceptable efficacy profile.


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THANK YOU

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