A 45-year-old woman who was admitted with concurrent primary biliary cirrhosis or cholangitis (PBC) and bullous pemphigoid died 5 days after admittance, according to a case report from N.B. Guerra-Uribe, MD, and M.S. González-Huezo, MD.
The patient was admitted to the emergency department for dermatosis, which had been present for 21 days. The patient had also been diagnosed with PBC, which was in an advanced stage. Vesicular lesions had appeared on the right upper limb and disappeared spontaneously, only to reappear on the lower extremities. Examination revealed large blisters with a fibrin base and necrotic edges.
A skin biopsy showed that the lesions were subepidermal blisters with a superficial, mixed, perivascular inflammatory infiltrate consistent with bullous pemphigoid. During the hospitalization, the patient developed a catheter-related urinary tract infection, acute renal lesions, and spontaneous bacterial peritonitis. The patient developed septic shock due to the urinary tract infection and died 5 days after admittance.
“The unfortunate case of our patient reflects the delay in seeking medical attention that resulted in a fatal outcome. In addition, early disease onset is associated with a worse prognosis and a higher failed treatment rate,” the investigators wrote.
They reported having no relevant financial conflicts.
Find the full case report in the Revista De Gastroenterologia De Mexico (doi: 10.1016/j.rgmx.2015.08.004).