Ayer Hitam community participations in conservation: a conceptual paper
Introduction: Bullous pemphigoid is a rare acquired, chronic autoimmune blistering disease; which typically produces tense and large blisters with erosions on skin or mucous membrane. It is primarily affects elderly patients in the fifth to seventh decade of life and can be fatal, particularly...
| Main Authors: | , |
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| Format: | Conference or Workshop Item |
| Language: | English English |
| Published: |
2020
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/78143/ http://irep.iium.edu.my/78143/ http://irep.iium.edu.my/78143/1/gabapentin%20oral%20pemphigoid.pdf http://irep.iium.edu.my/78143/11/E%20BOOK%201st%20EAST%20COST%20MWHS%202020.pdf |
| Summary: | Introduction: Bullous pemphigoid is a rare acquired, chronic autoimmune blistering disease; which
typically produces tense and large blisters with erosions on skin or mucous membrane. It is
primarily affects elderly patients in the fifth to seventh decade of life and can be fatal,
particularly in patients who are debilitated, with underlying medical problems or left untreated
because of misdiagnosis. There are various factors documented able to facilitate bullous pemphigoid
such as physical agents, viral infections and drug intake including gabapentin. Gabapentin is an
anticonvulsant drugs, but also widely used in the management of neuropathic pain especially in
primary care. Even it is rare, gabapentin has been found to cause bullous pemphigoid from the
previous literatures. Nevertheless, the previous reported cases were mainly involving trunks and
limbs; spared the oral cavity. Report: We herein report a case of a 66-year-old gentleman, who
presented with swollen, itchy and tender upper and lower lips with localized erythematous macular
rashes over left side of his face for two days duration. He had a history of taking oral
gabapentin 300mg three times a day for one week prior to the onset of the lesions. The drug was
prescribed in the primary care clinic for his neuropathic pain secondary to bilateral lower limb
atherosclerotic gangrene. Examination revealed multiple bullous over his swollen upper lips with
desquamative gingivitis. Other system examinations were unremarkable. The offending drug was
immediately ceased and he was then referred to Dermatology team for further evaluation. Result: The
diagnosis of Gabapentin-induced bullous pemphigoid was confirmed by clinical assessment and
histopathological examination. His symptoms gradually improved after a week commencement of high
potency topical corticosteroid. Conclusion: This case illustrates the importance of adequate
physical examination including detailed oral examination to look for the pathognomonic features in
a case suspected to be drug induced rashes. Indeed, adequate knowledge on the side effect of the
possible medication that can induce catastrophe skin problem and prompt action to withhold the
precipitating drug is really essential in primary care in order to save the
pati ent’ s l i fe. |
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