Brief Answer:
Pemphigus vulgaris
Detailed Answer:
Hi. Thanks for posting your concern at HCM.
Pemphigus vulgaris is an
autoimmune blistering disease characterised by flaccid intraepidermal bullae, which rupture easily and leave behind painful erosions. The erosions can involve the scalp, oral mucosa, lips, trunk and abdomen, groin and genitals.
Your mother has been on Omancortil, which is an oral steroid whereas Aziron is Azithromycin, an oral antibiotic.
Pulse Therapy: Pulse therapy for pemphigus offers the only chance of long term cure/remission and is considered to be relatively safe and side effects are minor and few as compared to daily oral steroids. The common side effects are generalized weakness and fatigue, gastrointestinal symptoms, menstrual irregularities, alopecia, candidiasis,
dermatophytosis,
hypertension and urinary symptoms.
Management options for pemphigus vulgaris:
Topical and systemic treatment
Topical:
-Topical steroids
-Topical antibiotics
Systemic:
-Oral steroids
-
Oral antibiotics like
tetracycline and erythromycin
-Cyclophosphamide
-Mycophenolate Mofetil
-Azathioprine
-Methotrexate
Since daily oral steroids have a lot of adverse effects like weight gain, weakening of the bones (
osteoporosis), diabetes,
high blood pressure, glaucoma, cataracts etc they should not be continued alone forever, but instead patients should be simultaneously started on various other safer but slow acting options (steroid sparing agents) like cyclophosphamide, Mycophenolate Mofetil, Azathioprine, OR Methotrexate.
Steroids can be tapered gradually and finally stopped once the steroids sparing agents take full control of the disease.
Pulse therapy therefore has many advantages over daily oral steroids besides offering the only realistic chance of cure or long term remission. It can be administered only in an hospital setting and usually is available in a medical college associated hospital/research hospital.
take care
regards