CASE STUDY 1 - Pemphigus

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                 A male aged 33 years, married and having children. He developed small blisters in the mouth and then in the scalp two and half years back. Initially the blisters disappeared on their own. Gradually more and more appeared all over the body. He was diagnosed as P.V by dermatologists. He was hospitalised for about a month and was given critical care. His hospitalisation became frequent and prolonged. During his hospitalisation he received massive doses of Inj. Betamethazone, oral prednisolone, anti-biotics etc., Yet this condition was progressive. He changes his hospital and doctor. This time the new dermatologist added cyclophosphamide 100mg/day. Cyclophosphamide is an anti-cancer immunosuppresive drug.Full doses of Glucocorticoids and immunosupprusive drug could not control this condition. Even intensive hospitalisation could not help. Losing hope, relatives brought him home and he was mentally depressed expecting the end.

                On a request from a doctor, who was the family friend of the patient, Dr.Thas visited him. At that time, the patient was having extensive blisters, scalling and crusts all over his sides, back, thighs and lower part of the abdomen. He had ulcers in the mouth and in both eyes. He complained of intractable pain all over the body, nausea, vomiting and diarrhea. The whole room was stinking. His bio-chemical para-meters were abnormal. Blood picture showed bonemarrow depression.

                He was lying on plantian leaves. In Tamilnadu it is an age old custom to put the patient of burns and small pox on plaintain leaves. At that time the patient was taking the following drugs:

Tab. Predisolone 40 mg / day

Tab. Cyclophosphamide 100mg / day

Cap. Cephelaxin 500 mg T.I.D.

Tab. Ranitidin 150 mg B.I.D.

Cap. Vit. E 400 mg O.D.

Cap. B. Complex B.I.D.

Tab. Nimuselide 100 mg B.I.D.

                  Inspite of the above medicines he was sinking. Herbal drugs were inroduced without withdrawing any of the above allopathic drug. Within two weeks his condition became stable. Cyclophosphamide was tapered and stopped, within another two months. Cephelaxin was stopped within a month. In the course of the treatment occassionly small blisters appeared.

                 There is no new blisters at present. Crusts and scales that looked like fur slowly shed. Now he is happy and healthy and is able to wear normal clothes. His initial weight of 77 kg is maintained.

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