Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings

Authors

DOI:

https://doi.org/10.3126/njdvl.v20i1.43296

Keywords:

Dexamethasone, Myocardial Infarction, Pemphigus vulgaris, Pulse therapy

Abstract

Pemphigus vulgaris is an autoimmune blistering disorder where biologics are the cornerstone of therapy. In resource-limited settings, a dermatologist should rely on systemic steroids. Dexamethasone pulse therapy is a cheap and established treatment of pemphigus where a supra-pharmacological dose of dexamethasone is used. High dose of dexamethasone is supposed to have atherogenic potential which could promote a hypercoagulable state. Here, we report a case of a 30-year-old woman in the resource-limited setting of Nepal, who was under monthly dexamethasone pulse therapy for pemphigus vulgaris, who had an acute episode of ST-segment elevated myocardial infarction. In such setting, although steroids are the cornerstone of therapy in various disorders, physicians should be equally cautious in using a high dose of steroids which might lead to fatal complications. This could probably be the first case report of steroid-induced acute myocardial infarction during treatment of pemphigus worldwide.

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Author Biography

Vikash Paudel, National Medical College and Teaching Hospital, Birgunj, Nepal

Associate Professor, Department of Dermatology

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Published

2022-03-29

How to Cite

Paudel, V. (2022). Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings. Nepal Journal of Dermatology, Venereology &Amp; Leprology, 20(1), 62–63. https://doi.org/10.3126/njdvl.v20i1.43296

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Section

Letters to the Editor