Tata Laksana Mucous Membrane Pemphigoid (MMP) yang Dipicu Oleh Obat Herbal

Abstract

Introduction: Mucous membrane pemphigoid (MMP) is a rare autoimmune disorder preceded with blisters various in size, commonly involving oral mucosa, conjunctiva, rarely the skin. This disorder often affects elderly female (over 50 years old) more than male. Diagnosis is very difficult to differentiate with other autoimun disorders involving mucosa, and often triggered by drugs. Purpose: This paper reports a management of MMP on an elderly javanese woman. Case: 60 year-old-woman complained of painful persistent ulsers since 3 months ago, without history of prodromal sympthoms. Clinical examination revealed multiple ulcers and eroded mucosa covered by pseudomembranes. Slight bleeding was observed. Dark brown, painful crusts were observed on lower lip. No lesion appears elsewhere. Patient admitted of consuming herbal medication. Management: several tests were ordered and patient was treated sympthomatically using antiseptic and anti-inflammatory mouthwash. Complete Blood Count (CBC) showed elevated ESR, direct mycology showed yeast formation, while liver function, renal function and blood glucose level were normal. Patient was then treated with oral corticosteroids, topical antifungal, immunomodulator and antiseptic mouthwash. Recovery was achieved within one month follow-up. Conclusion: The diagnosis of MMP was established based on history, clinical appearance and examinations. Treatment requires long-term administration of oral corticosteroids, therefore good cooperation between operators and patients is necessary, as well as patient adherence to taking medication and regular controls.