Bone mineral density in patients with pemphigus vulgaris on long-term steroid therapy

Background: Osteoporosis is a common side-effect seen with long term steroid therapy. Patients at increased risk are over 50 years of age, postmenopausal, or have restricted mobility. Objectives: To assess the bone mineral density (BMD) in patients with pemphigus vulgaris (PV) on long term steroid therapy. Patients and methods: All patients with pemphigus vulgaris on oral/parenteral steroid therapy at the Department of Dermatology, Unit I, Mayo Hospital, Lahore were enrolled. Their BMD was measured at the heel with a quantitative ultrasound device. A control group comprising of 20 patients was also taken within the same time period that suffered from skin diseases other than pemphigus vulgaris and were not taking steroids in any form. Results: There were 25 patients, 14 males and 11 females, with an average age of 33.8 years (range 12-60 years). The average duration of PV was 24 months (6 months to 12 years). The steroids used by these patients included prednisolone, betamethasone and dexamethasone. The duration of intake ranged from 2 months to 36 months. The highest dose was 120 mg and lowest was 10 mg. The mean BMD score of the patients was 0.39244 g/cm² and 0.45773 g/cm² for the control group. The mean T-score of the patients was -2.31, score was -2.61 in female patients and -2.08 in males. The score was -1.74 in the control group. Conclusion: All patients requiring long-term glucocorticoid therapy are candidates for osteoporosis prevention.