Pemphagus Vulgaris

Question

My sister is suffering from severe disease called Pemphagus vulgaris since 2017. She’s taking steroid almost everyday and that had been effected to her hip bones . She had three hipbones operations until now. As per doctor said the medicine has been badly effected to her hipbones . Please let me know

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Dr. Maria Arora · Answer

Deltacortil tab 2+2+2 for seven days
2+2 for seven days
Then 2 at night for 7 days
then 1 at night

Sp. Gaviscon 2+ 2 +2
Cap Risek 40 mg daily

Keep the area clean by bathing regularly with Safeguard soap.
See a physician.

Dr. Syed Ahmad Raza · Answer

Dear
I am sorry to know about your sister’s problem ie pemphigus vulgaris and complications/problems arising because of its treatment with steroids.
Weakening and unfortunately break (fracture) in bones especially hip and other long bones of the body are the side effects of steroid treatment in addition to many other side effects.
We have two challenges now
1. To keep the disease (pemphigus vulgaris) in adequate control so that it may not cause skin problem and
2. Keep the dose of steroids to minimum level in order to avoid the unwanted effects like weak bones (osteoporosis)

I would like to know few things
1. How is her skin condition now is it well controlled with the Prescription you shared here?
2. Have you ever got her bone (DEXA) scan done (please share report) if possible
3. Share the details of hip operations she had in the past

After looking into all these details I would be in a much better position to decide her further treatment plan

For now to strengthen her bones you can taper down the steroids as
3 + 3 for next week
2+ 2 another week
1+1 another week and stop
Keep on taking
Amorin (azathiopurine) regularly as prescribed by skin specialist
Take Tablet Alendrate 70 mg once a week half hour before meal and in standing position
There are few more treatment options to strengthen the bones
Please feel free to share all the details, reports, previous operations, answers to questions on zero three three three five five eight two eight nine two (Watsapp)
I wish her health
Regards

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Dr. Maria Arora - Pulmonologist / Lung Specialist

MBBS, MCPS (TB & Chest Diseases), Diploma (TB & Chest Diseases) | Lahore

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