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

Objective: To observe the safety of parenteral dexamethasone compared with oral prednisolone in the treatment of pemphigus vulgaris. Patients and methods: 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). Results: 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. Conclusion: Parenteral dexamethasone appears to be safer than oral prednisolone in the management of pemphigus vulgaris with an acceptable efficacy profile.