Multi-professional care for the patient affected by pemphigus vulgaris

Authors

  • Maikiane Aparecida Nascimento Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros State Public Health Laboratory (LACEN / GO), Goiânia, GO, Brazil https://orcid.org/0000-0002-6843-2809
  • Adryelli Joicyr Brito Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros, Goiânia, GO, Brazil https://orcid.org/0000-0002-2950-1525
  • Ildeny Alves dos Santos Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros State Public Health Laboratory (LACEN / GO), Goiânia, GO, Brazil https://orcid.org/0000-0003-4884-036X
  • Marielly Sousa Borges Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros State Public Health Laboratory (LACEN / GO), Goiânia, GO, Brazil https://orcid.org/0000-0003-0928-9771
  • Daniela Rosa da Silva Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros, Goiânia, GO, Brazil https://orcid.org/0000-0003-3760-9912
  • Jennifer David Silva Sakai Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros, Goiânia, GO, Brazil https://orcid.org/0000-0002-2980-0357
  • Ivia Carla Nunes Ferreira Clinical Pathology Service, Laboratory Padrão Diagnostics, Goiânia, GO, Brazil. https://orcid.org/0000-0001-5815-0915
  • Edna Joana Claudio Manrique Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros State Public Health Laboratory (LACEN / GO), School of Medical, Biomedical and Pharmaceutical Sciences - PUC –Goiás, Goiânia, GO, Brazil https://orcid.org/0000-0002-8632-3542
  • Lucélia da Silva Duarte Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros, Goiânia, GO, Brazil https://orcid.org/0000-0001-5744-1104

DOI:

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

Keywords:

Pemphigus; Delivery of health care; Patient care team.

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.

Author Biographies

Maikiane Aparecida Nascimento, Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros State Public Health Laboratory (LACEN / GO), Goiânia, GO, Brazil

Currently, resident of the Multi-professional Residency Program of the Goiás State Secretariat, located at the Hospital de Tropical Diseases Dr. Anuar Auad, working in the field of infectious diseases and at the State Public Health Laboratory Dr. Giovanni Cysneiros (LACEN / GO). Graduated in Biomedicine (2018) from the University of Oeste Paulista (UNOESTE), previously undertook Sandwich graduation at the Faculty of Pharmacy of the University of Porto - Portugal by the Santander Universidades - Ibero-American mobility scholarships program. Research lines: Microbiology, Clinical Mycology, tropical diseases, infectious diseases.

Adryelli Joicyr Brito, Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros, Goiânia, GO, Brazil

Currently a nutritionist, he is a resident of the Multi-professional Residency Program of the Secretariat of the State of Goiás, allocated at the Hospital for Tropical Diseases Dr. Anuar Auad, working in the field of infectious diseases. She has experience in food quality control, has served as director of academic leagues, in research, extension and activity projects aimed at health promotion.

Ildeny Alves dos Santos, Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros State Public Health Laboratory (LACEN / GO), Goiânia, GO, Brazil

Bachelor of Pharmacy from Universidade Paulista (2018/01). He is currently a Pharmacy Resident in the area of Infectious Diseases at the Hospital for Tropical Diseases Dr. Anuar Auad. She worked as a Laboratory Technician at Empresa Universidade Paulista in 2018. She was a Research and Innovation intern in the areas of cosmetology, pharmacy and food (Instituto Senai de Tecnologia - IST - Vila Canaã).

Marielly Sousa Borges, Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros State Public Health Laboratory (LACEN / GO), Goiânia, GO, Brazil

Graduated in Biomedicine at Faculdade União de Goyazes. During graduation, she monitored the subjects of general immunology and clinical immunology. He is currently a resident in infectious diseases through the multi-professional residency program of the Health Department of the State of Goiás (SES / GO) working at the Hospital for Tropical Diseases Dr. Anuar Auad (HDT) and at the Central Public Health Laboratory Dr. Giovanni Cysneiros (Lacen-GO ).

Daniela Rosa da Silva, Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros, Goiânia, GO, Brazil

Bachelor of Nursing from Salgado de Oliveira University (2018). Post graduated from the Multiprofessional Residency Program in Health of the State Health Department of Goiás, in the area of specialized clinical care in Infectious Diseases, held at the Hospital for Tropical Diseases Dr. Anuar Auad (2020).

Jennifer David Silva Sakai, Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros, Goiânia, GO, Brazil

Bachelor in Psychology from the Pontifical Catholic University of Goiás and postgraduate from the Multiprofessional Health Residency Program of the State Health Department of Goiás, in the area of specialized clinical care in Infectology. Currently, he is a graduate student in Analytical Behavioral Psychotherapy for Adults at the Skinner Institute. She was a Scientific Initiation student at the Experimental Behavior Analysis Laboratory (NPLAEC) of the referred University, addressing the concept and application of Metacontingencies and at the Management and Business Research Center (NUPEN), researching on the reflections of the organizational environment on health and social life of the worker. He has experience in hospital psychology and clinical psychology.

Ivia Carla Nunes Ferreira, Clinical Pathology Service, Laboratory Padrão Diagnostics, Goiânia, GO, Brazil.

Graduation and post-graduation in Medicine from the Federal University of Goiás (1996). Specialization and experience in Surgical Pathology and Cytopathology. Works with an emphasis on Dermatopathology. Medical examiner approved in a contest at the Civil Police of the State of Goiás (contest - 1999), filled since 2000 at the Instituto Médico Legal de Goiânia. Specialist in criminal medical examinations. Founding member of the Forensic Pathology sector of the Technical and Scientific Police of the State of Goiás (SPTC).

Edna Joana Claudio Manrique, Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros State Public Health Laboratory (LACEN / GO), School of Medical, Biomedical and Pharmaceutical Sciences - PUC –Goiás, Goiânia, GO, Brazil

Graduated in Biological Sciences Medical Modality from the Pontifical Catholic University of Goiás (1990), master's and doctorate in Health Sciences from the Federal University of Goiás (2007, 2009). He is currently an adjunct professor at the Pontifical Catholic University of Goiás, a biomedical doctor at the Public Health Laboratory Dr Giovanni Cysneiros (LACEN-GO) and Tutor at the Multiprofessional Residency of the State Health Department of Goiás, in the area of Infectious Diseases, biomedical axis. Operates in the area of Public Health. He has experience in the field of Biomedicine, working mainly on the following topics: cervical cancer, screening, quality control and health surveillance.

Lucélia da Silva Duarte, Dr. Anuar Auad State Hospital for Tropical Diseases (HDT) and Dr. Giovanni Cysneiros, Goiânia, GO, Brazil

Possui graduação em Enfermagem pela Pontifícia Universidade Católica de Goiás (1990) e mestrado em Medicina Tropical pela Universidade Federal de Goiás (2003). Atualmente, professora da Universidade Salgado de Oliveira, Servidora Pública no Hospital de Doenças Tropicais Dr Anuar AUAD/HDT exercendo as funções de Coordenadora e Tutora de Núcleo na Residencia Multiprofissional na área de Infectologia da Secretaria Estadual de Saúde de Goiás.

References

Akhtar, S. J., & Hasan, M. U. (1998). Treatment of Pemphigus: A Local Experience. J Pak Med Assoc, 48 (10), 300-4. Retrieved from https://pubmed.ncbi.nlm.nih.gov/10087750/

Beltran, C. E., Burgos, J., Subelza, H. E. G., & Ponce, J. B. (2016). Early diagnosis of penphigus vulgaris: case report. SALUSVITA, 35 (1), 95-100. Retrieved from https://secure.unisagrado.edu.br/static/biblioteca/salusvita/salusvita_v35_n1_2016_art_07.pdf

Brandão, E. S., Santos, I., Lanzillotti, R. S., Ferreira, A. M., Gamba, M. A., & Azulay-Abulafia, L. (2016). Nursing diagnoses in patients with immune-bullous dermatosis. Rev. Latino-Am. Enf, 24, 1-7. doi:10.1590/1518- 8345.0424.2766

Borges, E. L. (2005). Topical treatment of venous ulcers: proposal for an evidence-based guideline.Masters dissertation, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Dedee, F., Peña, S., Joly, P., Marinovic, B., Hashimoto, T., & Diaz, L. A. (2020). Diagnosis and Management of Pemphigus: Recommendations of an International Panel of Experts. Jour. of the Ame. Acad. of Derm., 82 (3), 575-585. doi:10.1016/j.jaad.2018.02.021

European Centre for Disease prevention and Control-ECDC. (2016) Healthcare-associated infections in intensive care units - Annual Epidemiological Report for 2016. Retrieved from https://www.ecdc.europa.eu/en/publications-data/healthcare-associated-infections-intensive-care-units-annual-epidemiological-0

Fonseca, L. A. F., Alves, C. M., Aprahamian, I., & Pinto, C. A. L. (2017) Pemphigus foliaceus as a differential diagnosis in vesicobullous lesions. Einstein, 15 (2), 220-2. doi:10.1590/S1679-45082017RC3828

Gonçalves, G. A., Brito, M. M. C., Salathiel, A. M., Ferraz, T. S., Alves, D., & Roselino, A. M. F. (2011). Incidence of pemphigus vulgaris exceeds that of pemphigus foliaceus in a region where pemphigus foliaceus is endemic: Analysis of a 21-year historical series. An Bras Dermatol., 86 (6), 1109-12. doi:10.1590/S0365-05962011000600007

Harman, K. E., Brown, D., Exton, L. S., Groves, R. W., Hampton, P. J., & Mustapa, M. F. (2017). British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris 2017. British Journal of Dermatology, 177, 1170–1201. doi:10.1111/bjd.15930

Kridin, K., Zelber-Sagi, S., & Bergman, R. (2017). Mortality and Cause of Death in Patients with Pemphigus. Acta Derm Venereol, 97, 607–611. doi: 10.2340/00015555-2611

Lakdawala, N., Babalola, O., Fedeles, F., McCusker, M., Ricketts, J., & Whitaker-Worth, D. (2013). The role of nutrition in dermatologic diseases: Facts and controversies. Clinics in Dermatology, 31 (6), 677–700. doi:10.1016/j.clindermatol.2013.05.004

Leite, D. F., Macedo, M. P., Simas, C. M. S., Souza, L. C. D., & Lopes, F. F. (2015). Pemphigus vulgaris in oral cavity: clinical case report. RFO, 20 (3), 367-371. doi:10.5335/rfo.v20i3.5272

Ludgwig, M. A. B., Muller, M. C., Redivo, L. B., Calvetti, P. U., Silva, L. M., & Hauber, L. S. (2008). Psychodermatology and the interventions of the health psychologist. Mudanças, 16 (1), 37-42. Retrieved from https://www.metodista.br/revistas/revistas-ims/index.php/MUD/article/view/911/970

Martins, C. P., & Luzio, C. A. (2017). HumanizaSUS policy: anchoring a ship in space. Com Saúd Edu., 21 (60), 13-22. doi:10.1590/1807-57622015.0614

Mazzotti, E., Mozzetta, A., Antinone, V., Alfani, S., Cianchini, G., & Abeni, D. (2011). Psychological distress and investment in one’s appearance in patients with pemphigus. Journal of the European Academy of Dermatology and Venereology, 25 (3), 285–289. doi:10.1111/j.1468-3083.2010.03780.x

Mendes, D. C., Santos, B. C. O., Oliveira, L. B., & Sabino, L. F. The importance of nutrition in the wound healing process. Revista Científica Univiçosa, 9 (1), 68-75. Retrieved from https://academico.univicosa.com.br/revista/index.php/RevistaSimpac/article/download/814/1116

Mentink, L. F., Mackenzie, M. W., Tóth, G. G., Laseur, M., Lambert, F. P. G., & Veeger, J. (2006). Randomized Controlled Trial of Adjuvant Oral Dexamethasone Pulse Therapy in Pemphigus Vulgaris. Archives of Dermatology, 142 (5), 570-76. doi:10.1001/archderm.142.5.570

Motta, M. S., Pacheco, E. S., Andrade, R. P., Chaves, J. R., Santos, F. C., & Oliveira, B. C. Theoretical-practical reflection of multiprofessional assistance to a patient with pegphic vegetant. Research, Society and Development, 9 (7), 1-12. doi:10.33448/rsd-v9i7.3786

Nazik, H., Mülayim, M. K., & Öztürk, P. (2018). Results of intravenous immunoglobulin use and treatment in the South Province of Turkey. Egyptian Journal of Dermatology and Venereology, 38 (1), 42-45 doi:10.4103/ejdv.ejdv_39_17

Oliveira, A. P. R., Luz, E., Negrello, B. G., Burci, L. M., Souza, S. J. P., & Piemonte, M. (2016). A nursing attention to patients with pemphigus vulgaris and pemphigus foliaceus (wildfire). Revista Gestão & Saúde, 15 (1), 27-33. Retrieved from http://www.herrero.com.br/files/revista/file0a0f857668893fb5587d5785a33fa113.pdf

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Methodology of cientific research. Retrieved from

https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1.

Pessanha, F. S., Barreto, B. M. F., Oliveira, B. G. R. B., Chrizostimo, M. M., Souza, D. F., & Mafort, TT. (2015). Main microorganisms found and products used in contaminated tissular lesions: an integrative review. Online braz j nurs, 14 (1), 95-105. Retrieved from http://www.objnursing.uff.br/index.php/nursing/rt/printerFriendly/5111/html_596

Porro, A. M., Hans, G., & Santi, C. G. (2019). Consensus on the treatment of autoimmune bullous dermatoses: pemphigus vulgaris and pemphigus foliaceus – Brazilian Society of Dermatology. Bra annais of Dermatol, 94 (2), 20-32. doi:10.1590/abd1806-4841.2019940206

Schmidt, E., Sticherling, M., Sárdy, M., Eming, R., Goebeler, M., & Hertl, M. (2019). S2k guidelines for the treatment of pemphigus vulgaris/foliaceus and bullous pemphigoid: 2019 update. Jour. of Deut. Dermato. Ges, 18 (5), 516-526. doi:10.1111/ddg.14097.

Tabolli, S., Pagliarello, C., Paradisi, A., Cianchini, G., Giannantoni, P., & Abeni, D. (2014). Burden of disease during quiescent periods in patients with pemphigus. British Journal of Dermatology, 170 (5), 1087–1091. doi: 10.1111/bjd.12836

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Published

20/07/2020

How to Cite

NASCIMENTO, M. A.; BRITO, A. J.; SANTOS, I. A. dos; BORGES, M. S.; SILVA, D. R. da; SAKAI, J. D. S.; FERREIRA, I. C. N.; MANRIQUE, E. J. C.; DUARTE, L. da S. Multi-professional care for the patient affected by pemphigus vulgaris. Research, Society and Development, [S. l.], v. 9, n. 8, p. e778986596, 2020. DOI: 10.33448/rsd-v9i8.6596. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/6596. Acesso em: 22 nov. 2024.

Issue

Vol. 9 No. 8

Section

Health Sciences

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Copyright (c) 2020 Maikiane Aparecida Nascimento, Adryelli Joicyr Brito, Ildeny Alves dos Santos, Marielly Sousa Borges, Daniela Rosa da Silva, Jennifer David Silva Sakai, Ivia Carla Nunes Ferreira, Edna Joana Claudio Manrique, Lucélia da Silva Duarte

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