Pemphigus foliaceus as a differential diagnosis in vesicobullous lesions

Fonseca, Louise de Almeida Ferreira; Alves, Célia Antônia Xavier de Moraes; Aprahamian, Ivan; Pinto, Clóvis Antônio Lopes

doi:10.1590/s1679-45082017rc3828

Cited by 9 publications

(5 citation statements)

References 5 publications

(5 reference statements)

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“…Consequently, we scheduled a follow‐up visit for our patient to communicate our findings to her, only to discover that she now has intra‐oral involvement of her lesions, a finding more consistent with BP compared to PF, given the latter's notable mucosal membrane‐sparing characteristic . We thus discontinued her two Lisinopril‐containing antihypertensive medications, replacing them with a calcium channel blocker (CCB) instead, and prescribed a high‐dose topical steroid for application twice daily on her lesions.…”

Section: Case Presentationmentioning

confidence: 99%

Lisinopril‐associated bullous pemphigoid in an elderly woman: a case report of a rare adverse drug reaction

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Musharrafıeh

Khattar

2018

Brit J Clinical Pharma

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An 87-year-old woman with a long-standing history of hypertension, hypothyroidism and diabetes presented to us with scaly and pruritic vesicles of an erythematous base and crusted surface of 2-month duration. They first appeared on her abdomen and gradually spread to her lower back, thighs, before spreading to her upper and lower limbs. Her lesions were non-painful, aggravated by sun exposure only, and sparing mucous membranes. Nikolsky sign was positive with no discernible fluid-filled bullae. History was remarkable only for a doubling of her Lisinopril dosage 2 months prior to the appearance of her lesions, with no other potential environmental and/or drug triggers recognizable on history taking. In light of the appearance of her lesions after her Lisinopril dose escalation, in the absence of any other discernible triggers, an adverse drug reaction (ADR) was entertained, yielding a corresponding Naranjo ADR probability score of 7. Particularly, drug-induced pemphigus foliaceus was initially suspected given her clinical presentation and the morphology and distribution of her lesions. However, her skin biopsy altered our diagnosis to drug-induced bullous pemphigoid (BP) instead, making this the second case reported to date on Lisinopril-induced BP, and the first to report a dose-response variant of this adverse reaction.

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Section: Case Presentationmentioning

confidence: 99%

Lisinopril‐associated bullous pemphigoid in an elderly woman: a case report of a rare adverse drug reaction

Ballout

Musharrafıeh

Khattar

2018

Brit J Clinical Pharma

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“…9 The mechanism of occurrence of Nikolsky 's sign is a The general management of PF consists of systemic corticosteroid therapy to inhibit antibody production, combined with the use of topical agents to prevent infection, protect areas of erosion and promote epithelialization. 10,11 Topical therapy for PF focuses on proper skin care and the use of topical medications.…”

Section: A B 2513mentioning

confidence: 99%

Application of Topical Autologous Platelet-Rich Plasma for Treatment of Pemphigus Foliaceus Wounds: A Case Report

et al. 2022

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Background: Pemphigus foliaceus (PF) includes lesions on the skin, generally without involving the mucosa. Wounds in PF arise on the outer layer of the superficial skin, but if left untreated, the wound will not heal and will multiply. Platelet-rich plasma (PRP) containing a variety of different growth factors can be used in wound care. This study was at a time to describe autologous PRP therapy in the treatment of excoriated erosional wounds in patients with pemphigus foliaceus. Case presentation: A woman, 35 years old, married, a housewife living in suburban, comes to the emergency department with complaints of blisters accompanied by pain in the face, body, and back which has been increasing since 1 month ago. Examination of the skin showed palpebral blisters on the eyelids of the left and right eyes. In the anterior and posterior trunk regions, proximal 1/3rd and suprapubic extremities, there are hyperpigmented erythematous macules, multiple, nummular-plaque, discrete, partially confluent, with white to brownish scales, single layer and exfoliative. In the posterior trunk region, Nikolsky's sign was positive. Laboratory evaluation showed an increase in leukocytes and neutrophils. ANA examination showed negative results and anti-ds-DNA 54.91. Management of pemphigus in the form of topical and systemic treatment. Topical management in the form of an open compress with 0.9% NaCl solution, Intrasite gel®, and closed Cutimed sorbact® for erosion and excoriation. Topical PRP was administered on the 7th day of treatment. On the 14th day after treatment with topical PRP, the patient is allowed to go home with the repair of lesions throughout the region. Conclusion: PRP therapy in cases of pemphigus foliaceus is very useful in improving the clinical condition of the patient.

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“…Se denomina pénfigo (del griego «pemphix» que significa ampolla) a un grupo de enfermedades autoinmunes, que producen ampollas en la piel y en las membranas mucosas, debido a la acción de autoanticuerpos sobre proteínas específicas de los hemidesmosomas 1 , esto genera una pérdida de la adhesividad entre las células epidérmicas, caracterizadas histológicamente, por la formación de ampollas intraepidérmicas, proceso conocido como acantólisis 2,3 . La definición clásica del pénfigo la describe como una enfermedad de carácter grave, poco común que evoluciona de manera crónica y agresiva.…”

Section: Introductionunclassified

Pénfigo foliáceo, variedad seborreica, reporte de caso

Linares Rosales,

Brizuela Alfaro,

Arévalo Mojica

2023

Alerta (San Salvador)

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Presentación del caso. Se expone el caso de un paciente masculino de 48 años de edad, sin antecedentes médicos conocidos, que presentó múltiples lesiones en forma de placas eritematocostrosas fácilmente descamativas, inicialmente en tórax anterior, que se esparcían sobre el rostro y cuero cabelludo sin afectar las mucosas. Intervención terapéutica. El manejo hospitalario se basó fundamentalmente en el uso de esteroides tópicos y sistémicos, así como el manejo de las infecciones sobreagregadas a las lesiones dermatológicas, y el apoyo psicológico del paciente. Se tomó biopsia de piel donde se evidenció la presencia de acantólisis, confirmando el diagnóstico de esta enfermedad autoinmunitaria.Evolución clínica. Luego del tratamiento se logró una reducción de las múltiples lesiones descamativas, el control de la infección local y la recuperación de la piel del paciente, la cual a pesar de aún presentar cicatrices se encontraba con sus funciones restituidas.

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Pemphigus foliaceus as a differential diagnosis in vesicobullous lesions

Cited by 9 publications

References 5 publications

Lisinopril‐associated bullous pemphigoid in an elderly woman: a case report of a rare adverse drug reaction

Lisinopril‐associated bullous pemphigoid in an elderly woman: a case report of a rare adverse drug reaction

Application of Topical Autologous Platelet-Rich Plasma for Treatment of Pemphigus Foliaceus Wounds: A Case Report

Pénfigo foliáceo, variedad seborreica, reporte de caso

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