Management of Suspected Pemphigus Vulgaris in Elderly Patient with Chronic Diseases

Ayu M Prihanti,Muhammad Jusri

doi:10.14693/jdi.v20i1.129

Abstract

72 1024x768 Pemphigus vulgaris (PV) is a group of vesicobullous disease affecting skin and mucous membranes. PV is associated with autoimmune diseases, characterized by binding of IgG autoantibodies to desmoglein 3. PV lesion is a thin-walled bulla arising on the skin or mucosa. Oral mucous bulla are fragile and easily breakdown, forming irreguler ulcers. There are several factors that trigger PV, including genetic factors, age, drugs and food. This paper aimed to report treatment of suspected pemphigus vulgaris in elderly patient with history of chronic diseases. A 75-year-old woman with 2 months history of bulla formation on skin and history of persistent oral ulceration. Ulcers were covered with fibrin and erosive erythematous on labial, buccal and gingival mucosa. History of hypertension, diabetes mellitus and hepatitis was revealed. Routine complete blood count showed thrombocytopenia. Diagnosis was confirmed by anamnesis, clinical examination and complete blood investigation. PV should be distinguished from other vesicobullous disease. Systemic corticosteroid was given concurrently with hepato-protector, mouthwash, supportive therapy and topical lip cream. Bulla on skin and persistent erosive ulcers of the oral mucosa are the manifestations of PV. Elderly patient with history of chronic diseases showed a complex care of PV requiring more intensive and comprehensive treatment. DOI: 10.14693/jdi.v20i1.129

Highlights

Pemphigus vulgaris (PV) yang merupakan kelompok penyakit vesikobulosa, menyerang kulit dan membran mukosa
PV is associated with autoimmune diseases
a thin-walled bulla arising on the normal skin

Summary

Introduction

Pemphigus vulgaris (PV) yang merupakan kelompok penyakit vesikobulosa, menyerang kulit dan membran mukosa. Biasanya lesi oral muncul kurang lebih 4 bulan sebelum lesi pada kulit muncul.[3,5,9,10] Penegakan diagnosis PV dilakukan berdasarkan riwayat penyakit, pemeriksaan klinis untuk membedakan PV dengan lesi vesikobulosa yang lain, dan pemeriksaan imunof lorensi. Gambaran klinis pasien saat kontrol I A;;B: Erosi pada mukosa bukal kiri dan kanan serta dan gingiva posterior rahang atas kiri dan kanan;; C: Krusta pada bibir bawa dan ulser pada mukosa labial bawah kiri darah puasa (141mg/dl);; peningkatan glukosa darah 2 jam PP (168mg/dl).

Objectives

Results

Conclusion