Dexamethasone cyclophosphamide pulse therapy: some suggestions for modifications.

Sir, It was truly enlightening and educative reading the editorial on dexamethasone pulse therapy in dermatology and the associated viewpoint by Prof. Pasricha who is widely regarded as the father of pulse therapy in India. Pulse therapy has altered the management and outcome of autoimmune diseases in general and pemphigus in particular. It has slowly but surely replaced the conventional dosing schedules for administration of oral steroids. In response to Dr. Ramam’s query (where do we go from here?), I would like to propose the following suggestions for modifications in the time tested though somewhat rigid protocol of pulse therapy: