Important Role of Caregiver in Management of Systemic Lupus Erythematosus on Patient with Mental Retardation

Abstract

<p class="AbstractContent"><strong>Background:</strong> Systemic Lupus Erythematous (SLE) is a chronic autoimmune disease causing inflammation, pain and tissue damages. The systemic steroid and antimalarial agents are SLE’s standard therapies. The challenges in achieving significant result include the extended period of treatment. Therefore, the patients' compliance to the dentist’s treatment is crucial. There are some conditions where patient's compliance is difficult to obtain, for example in patients with mental retardation. To be able to receive information and treatment well, it takes an important role of caregiver to communicate and to assist the daily care.</p><p class="AbstractContent"><strong>Objective</strong>: To give an overview of management challenges of a case of SLE in a patient with mental retardation in which requires good cooperation with the caregiver to obtain optimal results.</p><p class="AbstractContent"><strong>Case report and management</strong>: A 22-year-old female patient with mental retardation with her caregiver, counseled from the Department of Dermatology and Venereology of Cipto Mangunkusumo Hospital (RSCM) with a working diagnosis of Bullous Systemic Lupus Erythematous. She had been on three years’ treatment for blisters all over her body. Condition improvement of the skin had occurred a week before the visit, accompanied by a history of canker sores on her lips and mouth for three days. Clinical features on lips and mouth showed the oral manifestations of bullous SLE. Topical corticosteroids, alternately with saline, as well as clobetasol propionate 0.05% cream for topical treatment in lips, have given for therapies. The caregiver has been educated to help the patient for maintaining her oral hygiene and using her drugs on a regular basis. Improving the teeth and mouth condition and patient compliance levels seen in control visits.</p><p class="AbstractContent"><strong>Conclusion</strong>: Effective communication, information, and education to the caregiver are critical in the management of SLE patient with mental retardation. Establishment of trust and equality goals of care is necessary to overcome the limitations of communication and patient compliance in this case.</p>