[Anesthesia for a patient with pemphigus erythematosus]

Area of Science:

• Dermatology
• Anesthesiology
• Autoimmune Diseases

Background:

• Pemphigus erythematosus is a rare autoimmune blistering disease affecting skin and mucous membranes.
• Surgical procedures in these patients necessitate meticulous care due to fragile skin.
• Systemic lupus erythematosus and myasthenia gravis, common comorbidities, were absent in this case.

Observation:

• An 82-year-old female with pemphigus erythematosus underwent head of femur replacement.
• Skin and mucous membrane fragility were primary concerns during anesthetic management.
• Potential for airway trauma and blistering during intubation was a significant risk.

Findings:

• Spinal anesthesia was chosen to avoid airway manipulation and reduce physical stimulation.
• The procedure was completed without serious perioperative complications.
• Minor blistering around the surgical wound was the only noted complication.

Implications:

• This case demonstrates the successful anesthetic management of a pemphigus erythematosus patient.
• Spinal anesthesia is a viable option for minimizing risks in such patients.
• Careful anesthetic planning can prevent perioperative complications in autoimmune blistering diseases.