LOCAL ANESTHESIA CARE IN PATIENTS WITH PEPHIGUS BULLOSUS

Abstract

Bullous pemphigoid is a rare autoimmune disease characterized by the formation of blisters on the skin and mucous membranes due to the production of autoantibodies against proteins of the dermoepidermal junction. Treatment generally includes the use of systemic corticosteroids and immunosuppressants, but the need for surgical procedures such as blister drainage and debridement is also common. Objective: to evaluate and synthesize the available evidence on local anesthesia care in patients with bullous pemphigoid. Methodology: this review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Searches were carried out in the PubMed, Scielo and Web of Science databases, using the following descriptors: "bullous pemphigoid", "local anesthesia", "perioperative care", "surgical complications" and "blister treatment". The inclusion criteria considered studies published in the last 10 years, covering original articles, systematic reviews and case studies related to local anesthesia care in patients with bullous pemphigoid. Three relevant inclusion criteria were: studies that addressed local anesthesia in patients with bullous pemphigoid, studies that reported perioperative complications and studies that discussed strategies to minimize surgical risks in patients with the disease. On the other hand, three exclusion criteria were applied: studies focusing exclusively on other dermatological conditions, studies with insufficient data on the topic and studies not available in English or Portuguese. Results: 15 articles were selected. The results indicated that the use of local anesthesia in patients with this condition requires special attention to the fragility of the skin and the possibility of new blisters forming. The use of fine needles is recommended to minimize skin trauma during the administration of local anesthesia. Furthermore, strategies to avoid excessive manipulation of the skin, such as the use of delicate forceps and careful sutures, are crucial to prevent surgical complications. Conclusion: The systematic literature review highlighted the need for delicate techniques and careful surgical strategies to avoid excessive skin trauma. Furthermore, effective patient communication plays a key role in the successful management of local anesthesia. These findings provide valuable guidance for healthcare professionals caring for patients with bullous pemphigoid undergoing surgical procedures, contributing to a safer and more effective approach to managing this complex condition.