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PEMPHIGUS
VULGARIS
RATHEESH R L
• It is the chronic disorder of the skin and oral
mucous membrane which is characterized by
blister or bullae formation.
• It is a type of autoimmune disease which
occurs because of antigen antibody reaction.
RISK FACTORS
• The main risk factor is the use of drugs like
penicillin and captopril
CLINICAL FEATURES
• The blisters will be appear in mouth and the
scalp firstly and then spreads to face, back,
chest, umbilicus and groins.
• The blister will rupture and resulting in
crusting and oozing of fluid with fowl smell.
• Pain
• Nikolsky’s sign (the pressure within the blister
leads to the spread of blister to adjacent
tissues)
• Septicemia
• Blisters in your mouth or throat may make it
hard to swallow and eat.
DIAGNOSIS
• History collection
• Physical examination
• Immunofluroscence microscopy is used to
determine the presence of Ig G in serum and
epidermis.
• Skin biopsy is performed as a confirmation
test for pemphigus vulgaris
MANAGEMENT
The following prescription medications may be
used alone or in combination, depending on the
type and severity of pemphigus.
• Corticosteroids. For people with mild disease,
corticosteroid cream may be enough to control
it. For others, the mainstay of treatment is
corticosteroids, such as prednisone pills and
hydrocortisone.
• Immunosuppressants
Medications such as
azathioprine (Imuran) or mycophenolate mofetil
(CellCept) help keep your immune system from
attacking healthy tissue.
They may have serious side
effects, including increased risk of infection.
• Biological therapies.
The doctor may suggest a drug called
rituximab (Rituxan) if other medications aren't
helping or are difficult to tolerate.
This drug is given as an injection. It
targets the white blood cells responsible for the
production of the pemphigus antibodies
• Antibiotics, antivirals and antifungal
medications.
These may be used to control
or prevent infections.
Lifestyle and home remedies
• Follow your doctor's wound care
instructions……….Taking good care of your
wounds can help prevent infection and
scarring.
• Use talcum powder………. Generously
sprinkling talcum powder on your sheets may
help keep oozing skin from sticking.
• Take your medicines as
prescribed……….. Stopping or changing the
dose could cause your condition to worsen.
• Clean towels, linens and
clothing…………. Frequent cleaning of these
items helps prevent your blisters and sores
from becoming infected. Also, don't share
such items with others.
• Protect your skin………… Avoid activities that
may hurt or contaminate your wounds, such
as playing contact sports or using a hot tub.
• Avoid certain foods………. Blisters in your
mouth could be triggered or irritated by some
foods, such as garlic, onion and abrasive
foods.
• Minimize sun exposure…….. Ultraviolet light
may trigger new blisters.
NURSES ROLE
• Advice the patient to maintain oral hygiene
and use lip balms to prevent the cracking of
the lips.
• Skin should be dried properly after bathing
and large amount of non irritating powder
should be applied.
• Observe the patient for any signs of infection
like fever, chills, rashus etc
• Intake output chart should maintain properly
• Maintain adequate fluid intake
• High caloric, high protein diet should be
provided to the patient.
Pemphigus vulgaris

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Pemphigus vulgaris

  • 2. • It is the chronic disorder of the skin and oral mucous membrane which is characterized by blister or bullae formation. • It is a type of autoimmune disease which occurs because of antigen antibody reaction.
  • 3.
  • 4. RISK FACTORS • The main risk factor is the use of drugs like penicillin and captopril
  • 5. CLINICAL FEATURES • The blisters will be appear in mouth and the scalp firstly and then spreads to face, back, chest, umbilicus and groins. • The blister will rupture and resulting in crusting and oozing of fluid with fowl smell. • Pain • Nikolsky’s sign (the pressure within the blister leads to the spread of blister to adjacent tissues)
  • 6. • Septicemia • Blisters in your mouth or throat may make it hard to swallow and eat.
  • 7. DIAGNOSIS • History collection • Physical examination • Immunofluroscence microscopy is used to determine the presence of Ig G in serum and epidermis. • Skin biopsy is performed as a confirmation test for pemphigus vulgaris
  • 8. MANAGEMENT The following prescription medications may be used alone or in combination, depending on the type and severity of pemphigus. • Corticosteroids. For people with mild disease, corticosteroid cream may be enough to control it. For others, the mainstay of treatment is corticosteroids, such as prednisone pills and hydrocortisone.
  • 9. • Immunosuppressants Medications such as azathioprine (Imuran) or mycophenolate mofetil (CellCept) help keep your immune system from attacking healthy tissue. They may have serious side effects, including increased risk of infection.
  • 10. • Biological therapies. The doctor may suggest a drug called rituximab (Rituxan) if other medications aren't helping or are difficult to tolerate. This drug is given as an injection. It targets the white blood cells responsible for the production of the pemphigus antibodies
  • 11. • Antibiotics, antivirals and antifungal medications. These may be used to control or prevent infections.
  • 12. Lifestyle and home remedies • Follow your doctor's wound care instructions……….Taking good care of your wounds can help prevent infection and scarring. • Use talcum powder………. Generously sprinkling talcum powder on your sheets may help keep oozing skin from sticking.
  • 13. • Take your medicines as prescribed……….. Stopping or changing the dose could cause your condition to worsen. • Clean towels, linens and clothing…………. Frequent cleaning of these items helps prevent your blisters and sores from becoming infected. Also, don't share such items with others.
  • 14. • Protect your skin………… Avoid activities that may hurt or contaminate your wounds, such as playing contact sports or using a hot tub. • Avoid certain foods………. Blisters in your mouth could be triggered or irritated by some foods, such as garlic, onion and abrasive foods. • Minimize sun exposure…….. Ultraviolet light may trigger new blisters.
  • 15. NURSES ROLE • Advice the patient to maintain oral hygiene and use lip balms to prevent the cracking of the lips. • Skin should be dried properly after bathing and large amount of non irritating powder should be applied. • Observe the patient for any signs of infection like fever, chills, rashus etc
  • 16. • Intake output chart should maintain properly • Maintain adequate fluid intake • High caloric, high protein diet should be provided to the patient.