Pemphigus Vulgaris Management in Elderly Patient: A Case Report

Prayogi Miura Susanto, Wisyanti Mian Uli Siahaan

Abstract

Pemphigus vulgaris is an autoimmune disease characterized by mucocutaneous involvement in the form of loose bullae on the skin and mucous membranes. This disorder is typically associated with the poor general condition and can be life-threatening. Furthermore, it has a rare incidence among elders. Pemphigus vulgaris was reported in a 73-year-old female patient. The diagnosis was performed clinically according to the history of the disease course and its typical lesions with a predilection for location. The patient's clinical condition improved after receiving systemic corticosteroids and additional supportivetherapy.

Keywords

corticosteroid; elderly; management; pemphigus vulgaris

Full Text:

PDF

References

  1. Kridin K, Schmidt E. Epidemiology of pemphigus. JID Innov. 2021;1(1):1–13.
  2. Payne A, Stanley J. Pemphigus. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors Fitzpatrick's dermatology in general medicine. 9th ed. United States: McGraw-Hill; 2019. p. 910–25.
  3. Joly P, Horvath B, Patsatsi, Uzun S, Bech R, Beissert S, et al. Updated S2K guidelines on the management of pemphigus vulgaris and foliaceus initiated by the european academy of dermatology and venereology (EADV). J Eur Acad Dermatology Venereol. 2020;34(9):1900–13.
  4. Sanders W. A brief review of pemphigus vulgaris. Biomed Dermatol. 2017;1:1–5.
  5. Jelti L, Cordel N, Gillibert A, Lacour JP, Uthurriague C, Doutre MS, Incidence and Mortality of Pemphigus in France. J Invest Dermatol. 2019;139(2):469–73.
  6. Wardhana M, Rusyati L. Prevalence and quality of life of pemphigus patients at Sanglah General Hospital Bali-Indonesia. Bali Med J. 2013;2(1):42–5.
  7. Amagai M. Pemphigus. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors Dermatology. 3th ed. United States: Elsevier Saunders; 2012. p. 461–72.
  8. Gonzalez-Serrano J, Paredes V, Lopez-Pintor R, Arriba L, Hernandez G. Successful treatment of oral pemphigus vulgaris in an insulin-dependant geriatric patient. Gerodontology. 2015;1–4.
  9. Masjedi M, Asilian A, Shahmoradi Z, Dehnavi P, Naeini B. Successful treatment of pemphigus vulgaris with the extensive mucocutaneous lesions in an elderly patient. Iran Red Crescent Med J. 2014;16(6):1–4.

10. Tarakji B. Pemphigus vulgaris in old patient. Case Rep Dent. 2021;1–3.

11. Suryawati N, Praharsini IGAA, Wardhana M, Darmaputra IGN. A coexistence of pemphigus vulgaris and type II diabetes in geriatric patient: a case report. Bali Med J. 2020;9 (1):314–7.

12. Prihanti A, Jusri M. Management of suspected pemphigus vulgaris in elderly patient with chronic diseases. J Dent Indones. 2013;20(1):20–4.

13. Simon K, Hollander G, McMichael A. Evolution of the immune system in humans from infancy to old age. Proc R Soc B. 2015;282:5–7.

14. Castelo-Branco C, Soveral I. The immune system and aging: a review. Gynecol Endocrinol. 2013;1–7.

15. Chen DM, Odueyungbo A, Csinady E, Gearhart L, Lehane P, Cheu M, et al. Rituximab is an effective treatment in patients with pemphigus vulgaris and demonstrates a steroid-sparing effect. Br J Dermatol. 2020;182(5):1111–9.

16. Hertl M, Jedlickova H, Karpati S, Marinovic B, Uzun S, Yayli S, et al. Pemphigus: S2 guideline for diagnosis and treatment – guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV). JEADV. 2015;29:405–14.

17. Harman K, Brown D, Exton L, Groves R, Hampton P, Mohd Mustapa M, et al. British association of dermatologists' guidelines for the management of pemphigus vulgaris 2017. Br J Dermatol. 2017;177:1170–201.

18. Gregoriou S, Efthymiou O, Stefanaki C, Rigopoulos D. Management of pemphigus vulgaris: challenges and solutions. Clin Cosmet Invest Dermatol. 2015;8:521–7.

19. Porro A, Seque C, Ferreira M, Enokihara M. Pemphigus vulgaris. Bras Dermatol. 2019;94(3):264–78.

20. Kridin K. Emerging treatment options for the management of pemphigus vulgaris. Ther Clin Risk Manag. 2018;14:757–78.

21. Grünwald P, Mockenhaupt M, Panzer R, Emmert S. Erythema multiforme, Stevens-Johnson syndrome/toxic epidermal necrolysis – diagnosis and treatment. J Ger Soc Dermatol. 2020;18(6):1–7.

22. Frantz R, Huang S, Are A, Motaparthi K. Stevens–Johnson syndrome and toxic epidermal necrolysis: a review of diagnosis and management. Medicina (Mex). 2021;57:1–15.

23. Bernard P, Antonicelli F. Bullous pemphigoid: a review of its diagnosis, associations and treatment. Am J Clin Dermatol. 2017;18:513–28.

24. Kridin K, Bergman R. Assessment of the prevalence of mucosal involvement in bullous pemphigoid. JAMA Dermatol. 2019;155(2):166–71.

25. Goronzy J, Weyand C. Immune aging and autoimmunity. Cell Mol Life Sci. 2012;69:1615–23.

26. Liu D, Ahmet A, Ward L, Krishnamoorthy P, Mandelcom E, Leigh R, et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma Clin Immunol. 2013;9(30):2–3.

27. Kiran K, Madhukara J, Abraham A, Muralidharan S. Cutaneous bacteriological profile in patients with pemphigus. Indian J Dermatol. 2018;63(4):301–4.

28. Jain S V., Murrell DF. Psychosocial impact of inherited and autoimmune blistering diseases. Int J Women's Dermatology [Internet]. 2018;4(1):49–53. Available from: https://doi.org/10.1016/j.ijwd.2017.11.004

29. Halter J, Ouslander J, Studenski S, High K, Asthana S, Supiano M, et al. Hazzard's geriatric medicine and gerontology. 7th ed. New York: McGraw Hill Education; 2017.


DOI: https://doi.org/10.13057/smj.v5i2.61240

Refbacks

  • There are currently no refbacks.