Oral Mini - Pulse Steroid Therapy in the Treatment of Dermatological Diseases : Review of the Literature

Abstract

Background: Pulse therapy is a type of systemic management in which large amounts of medications are administered to patients in short time and intervals (e.g. weekly) to get the stronger effects of medication sooner and avoid long term use of them. Objective: To determine how therapy-resistant diseases respond to oral minipulse steroids . Methods: Articles with Mesh terms dermatology and were searched in PubMed database .we chose case reports and clinical randomized controlled trials on oral steroid minipulse therapies of diseases. Results: Most articles and case reports mentioned the successful treatment of refractory diseases like lichen planus, vitiligo and alopecia areata with oral mini -pulse steroids. Conclusions: Oral mini pulse has stronger beneficial effects and fewer side effects than daily systemic corticosteroids. Since it is administered twice weekly , patient compliance will be better. Therefore, oral corticosteroids minipulse can be a good alternative to daily systemic corticosteroids in dermatologic diseases. Egyptian Dermatology Online Journal Vol. 10 No 2: 1, December 2014 2 http://www.edoj.org.eg Introduction Corticosteroids have been used in since a long time ago. Pulse therapy is a type of systemic management in which large amounts of medications are administered to patients in short time and intervals (e.g. weekly) to get the stronger effects of medication sooner and avoid long term use of them [1]. Pulse steroid therapy was firstly used in a patient with renal allograft in 1969 [2]. Oral mini pulse (OMP) is a type of pulse steroid therapy which is given orally in intervals to patients[1]. It is more comfortable for patients to comply with than daily systemic steroid therapy [3]. Pasricha et al. [4] used OMP in the treatment vitiligo for the first time and later it was used in other dermatological conditions such as lichen planus, alopecia areata, nail dystrophy, infantile periocular hemangioma and etc. Our article is a short review about the clinical use of oral minipulse steroid in the treatment of different dermatological diseases to determine how therapy-resistant cases respond to oral steroid pulse therapy till now. Methods: We searched the PubMed data bank using the following MESH-terms: pulse therapy, steroid, dermatology. We limited our search for clinical trials and case reports on treating dermatologic refractory cases with only oral mini pulse steroids. We didn't have access to the most full articles so we used abstract forms of the articles. There were 7 case reports and 17 original articles found on oral minipulse therapy and diseases.