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Medline ® Abstract for Reference 14

of 'Approach to the patient with cutaneous blisters'

Blistering diseases in the elderly: diagnosis and treatment.
Sami N, Yeh SW, Ahmed AR
Dermatol Clin. 2004 Jan;22(1):73-86.
This article discusses the major blistering diseases in the geriatric population. The diagnosis of both immune- and non-immune-mediated blistering disorders can be confirmed with the help of histologic and immunopathologic studies. Various serologic assays, which are more specific, also can be used to confirm the diagnosis of autoimmune blistering diseases. These techniques have facilitated the diagnosis and allowed the institution of early treatment. The treatment of blistering disorders has included both localized and systemic treatments. Localized treatment involves topical care including the following measures: the prevention of trauma; soaking of blisters in antiseptic (potassium permanganate or aluminum subacetate) solutions; topical and intralesional corticosteroids; and the prevention and early treatment of infections with local or systemic antibiotics. Conventional oral systemic therapies that have proved to be beneficial include systemic corticosteroids, anti-inflammatory agents, and immunosuppressive agents. Because the elderly are more prone to the side effects of these systemic agents, it is crucial that routine hematologic tests be done and monitored until the treatments have been discontinued. Recently, newer alternative treatment modalities have proved to be successful in patients who failed to respond or developed multiple side effects to the conventional oral systemic agents. In conclusion, as cliniciansgain a greater understanding into the pathogenesis of these diseases, more specific molecular-targeted treatments will most likely become available.
Department of Dermatology, University of Alabama-Birmingham, 1919 7th Avenue South, SDB-76, Birmingham, AL 35294-0007, USA.