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Circatricial Pemphigoid - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Skin Hair and Nails
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3387 Questions
Doctor :   HI
Doctor :   How can I help you
Doctor :   It seems you are moved away from chat please login again for healthrealted queries
User :   Hi Doctor! I am tring to find someone who knows something about Cicatricial Pemphigoid, is this something you could help with?
Doctor :   yes
User :   wonderful!!
Doctor :   What do you want tio know
User :   my grandmother whom is 84 years old has been diagnosed with this condition, we live in a small town and the dr's here don't know enough about it to treat her properly, and i am afraid she is going to die
Doctor :   CP occurs in many parts of the body
Doctor :   what are your grandmom problems
User :   she started w/ sores on most of her upper body, ears, under breast, arm pits and the scalp. know it has moved into her mouth
Doctor :   Can you describe in details
User :   the soars have gotten to be so bad that she has a hard time consuming food and liquids . my mom had to bring her to the er tonite cuz she could not swallow anything all day, it would just sit in her throat and make a gurgling sound
Doctor :   Did it involve eye too
User :   the soars get to be the size of a quarter, sometimes bigger, they bleed all of the time. they gave her a save to use & it helps some but by the time the next morning she has another
Doctor :   For Administrative and health purposes, Please provide these details -Age: Gender: Occupation: Location: Marital Status: Dependants: Yes/No
User :   no, not yet, THANK GOD!!
Doctor :   IT is a very rare disease and heads off to the doctor to diagnose it correctly, often there is no test to say it is Cicatricial pemphigoid
Doctor :   autoimmune blistering diseases that predominately affects the mucous membranes, including the eye, and occasionally the skin
Doctor :   Skin involvement present with tense blisters and erosions, often on the head and the neck or at sites of injurya
User :   other than this she has been healthy , she is at home mostly but still is active we live in XXXX. her husband id diseased and she is 84 years old
Doctor :   Was the biopsy done
Doctor :   and pathology sent
Doctor :   report sent
User :   that is a perfect description of the blisters that she has
Doctor :   Most of the lesions arise in eye and mouth and skin
Doctor :   It is good that she has no eye involvement
Doctor :   Let me put to you some bitter facts about tthis CP
Doctor :   This disorder is extremely difficult to treat. Even with optimum control, blisters may continue to develop in some patients
Doctor :   Wound care of erosions includes daily gentle cleaning or compresses,
Doctor :   goals of wound care are to minimize trauma to the surrounding skin, to promote healing,
Doctor :   and reduce scarring
User :   i don't think that she has had a biopsy done. i know they talked about doing some kind of scope in the throat area, but nothing has been done yet and it seems like it is moving fast
Doctor :   The scopy is done to see if the upper airway is involved which is high possibility
Doctor :   and gradually leads to scarring and obstrution
Doctor :   and if so short cut airway is created
Doctor :   to minimise air hunger
Doctor :   management team typically includes a dermatologist with expertise in this area; an internist to assist with monitoring therapy, adverse effects of medications, and the patient's overall health; an ophthalmologist for ocular disease (no need for your granny); an otolaryngologist for upper airway evaluation and management; and a dentist for oral disease.
User :   i have read a lot about this and quite a few sites say with proper treatment that it is not life threating, but it's not looking so good on this end
Doctor :   anything that injures her is problematic
Doctor :   as it doesnt heal well and later scars
Doctor :   so see that she does hurt anytime
Doctor :   and next for the present erosions she
Doctor :   needs timely dressing and topical creams
Doctor :   applied
Doctor :   Although no dietary restrictions are necessary, patients with oral disease may benefit from avoiding foods high in acid, such as tomatoes and orange juice, and foods with hard surfaces that may mechanically traumatize the oral epithelium, such as chips, nuts, raw vegetables, and uncut fruit
Doctor :   so she should be given food in fluids and soft solids
Doctor :   She should take Calcium rich diet with VItamin D
Doctor :   may benefit by minimizing activities
User :   the ER doctors suggested to start puree foods and then made it worse by suggesting that later down the road a feeding tube
Doctor :   Ok
Doctor :   So is she on feeding tube
Doctor :   ?
User :   no
Doctor :   k
User :   still in beginning stages
Doctor :   Steroids are judiciously given to decrease the severtiy
Doctor :   may be application steroids
User :   but the DR's in area don't know much about it so I think they are having a hard time treating her
Doctor :   They should be knowing about it
Doctor :   because of the risks and benefits involved
User :   the steroids make her retain a ton of fluid in her leggs
Doctor :   wrt to tx they have to balance it
User :   so they stopped giving them
Doctor :   the applicative steroids
Doctor :   may not cause them
Doctor :   ok
Doctor :   so it s is very important to manage the acute erosions
Doctor :   but the treatment is definitely is steroids
User :   so how can we go about suggesting this method with out sounding rude
Doctor :   You cant suggest, the doctor suggest the options and you have to decide upon them
User :   when the soars surface we should be covering w/ cln , strl dressing then?
Doctor :   First of all take time to meet the doctor next time and ask him the options and the future prognosis
Doctor :   yes
User :   ok
Doctor :   When he describes the scene then you can put accross the decision
Doctor :   of yours to him
User :   thank you so much
Doctor :   Please fill this form I send, While I type the necessary information, and do Inform me when done.
User :   did you send to my email?
Doctor :   No
Doctor :   the feedback form
User :   oh
User :   sorry
Doctor :   did you fill it
User :   sent it back
Doctor :   Thanks for consulting Health care magic. Bye for now. Please refer your friends to our service
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