Multi-professional care for the patient affected by pemphigus vulgaris

Maikiane Aparecida Nascimento,Lucélia Da Silva Duarte,Jennifer David Silva Sakai,Adryelli Joicyr Brito,Ivia Carla Nunes Ferreira,Edna Joana Claudio Manrique,Marielly Sousa Borges,Ildeny Alves Dos Santos,Daniela Rosa Da Silva

doi:10.33448/rsd-v9i8.6596

Maikiane Aparecida Nascimento, Lucélia Da Silva Duarte + Show 7 more

Open Access

https://doi.org/10.33448/rsd-v9i8.6596

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Abstract

Patients suffering from pemphigus vulgaris need specialized care. Thus, in their comprehensive care, multi-professional action is essential to meet the different technical challenges of the disease. The objective was to report a case of pemphigus vulgaris and multi-professional performance. This is a descriptive study of the case report of a patient seen at a referral hospital for pemphigus. The information necessary to describe the case was collected after approval by the Research Ethics Committee. The patient arrived at the hospital with diffuse crusty lesions with associated pruritus throughout the body for approximately two months. After clinical evaluation and laboratory examination, the histological examination found the presence of a supra-basal intraepidermal bubble, with the presence of acantholytic cells inside the bubble, concluding as pemphigus vulgaris. During hospitalization, the patient had several secondary infections, used corticosteroids, analgesics, polyantibiotic therapy, and immunoglobulin. At the end of 78 days of hospitalization, he developed complications and died. Early diagnosis and the start of rapid treatment delay the evolution of the disease, improving the appearance of the lesions, which reduces the length of hospital stay and the risk of infections occurring. Therefore, the performance of the multi-professional team contributes to solving the challenges related to the disease, such as improvement in physical, emotional, nutritional, and patient safety. We emphasize measures for the prevention and control of infections, such as, for example, hand hygiene by all professionals, the use of personal protective equipment in the management of the patient, and adequate hygiene of the environment.

Highlights

Patients affected by pemphigus vulgaris need specialized care for the prevention of diseases, promotion of physical and mental well-being, and maintenance of life
The use of antimicrobials is always necessary for patients with pemphigus vulgaris, as complications related to the infection of the lesions may contribute to the death of hospitalized patients
A considerable growth of the basal epidermal cords occurs, forming villi over dermal papillae (Fonseca et al, 2017). These findings in the histopathological examination confirmed the diagnosis of pemphigus vulgaris in the present study

Summary

Introduction

Patients affected by pemphigus vulgaris need specialized care for the prevention of diseases, promotion of physical and mental well-being, and maintenance of life. The complexity of hospitalization relates with factors such as suffering, pain, the severity of the disease, and the deforming characteristics caused by the lesions. This disease has repercussions on the social and emotional aspects of the patient. It is an autoimmune disease evidenced by the presence of specific autoantibodies to the stratified squamous epithelium. It still has unknown pathophysiology and severe prognosis (Dedee et al, 2020). A histopathological examination demonstrating intraepidermal acantholytic vesicular dermatitis is necessary (Fonseca et al, 2017)

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