Extreme skin condition, 65 year old female Bangladesh,
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Hello
I need help for my mother in law. She is around 65 years old, lives in Sylhet Bangladesh. She has been healthy all her life and has not suffered any medical issues before this one.
She has had a skin issue which seems to be getting worse and worse as time passes. It began around seven years ago. Doctors in Sylhet Bangladesh have been unable to identify nor treat the condition.
This includes professors from Sylhet Medical College. She doesn't have the money to travel to the capital city where the better doctors are nor can she afford the fees.
We do not know if it is an allergy, or autoimmune or genetic or and infection of some kind.
I have included two photos of her. Please see.
Symptoms
The blisters appear all over her face and body. Seven years ago the blisters were small, now they are quite large, and she appears burnt. The blisters burst by themselves, with liquid coming out.
The area then dries and the skin peels. The liquid is coming from the blisters is clear. They appear a few at a time almost daily. They appear in the same places again and again as well as new places.
The ones on the face tend to be smaller then the ones on her body, and no liquid comes out on the face.
During the hot summer months, it is worse, in the cooler winter months it is less. She feels burning sensation and itching constantly. Her body is hot all the time. She is unable to keep her clothes on because of this. Loss of appetite.
She stays out the sunlight as much as possible and away from fire as this makes her feel worse. Please understand she spends most of her time indoors now for many years, where it is darker.
Sunlight and fires just makes it worse. Her urine is clear and normal.
No fever, nor nausea. Skin does not thicken around blisters but is thin and sensitive.
Medication
The medication she has received are ointments as follows.
Tacrolimus 0.1%
Betamethasone 0.05% with ClotrimaZole BP 1%
Silver SulfidiaZine USP 1%
Neomycin Sulphate, Bacitracin Zinc & Polyxin B Sulphate.
Oral medication.
Chlorpheniramine maleate
Oradexon
Methotrexate
Zinc Sulfate-folic acid
Background
Her normal diet is fresh vegetables, fish, rice and occasional chicken or red meat. Normal South Asian spices and cooked in soya bean oil. She lives in a village, fresh air but climate is humid and subtropical, mostly farmland, a lot of rivers.
No family history of a similar condition.
If anyone can help identify what this is and what the best course of treatment is, we would be grateful.
0 likes, 4 replies
mrsmop habib41841
Posted
Your poor mother in law.
I wondered whether she might have an autoimmune disease called Bullous Pemphigoid
https://patient.info/health/bullous-pemphigoid-leaflet
https://patient.info/health/bullous-pemphigoid-leaflet
The first leaflet should be for patients, the second for doctors, the second one has a picture to give you an idea.
Her skin will become thinner, partly with age but also because of the steroid creams, such as Betamethasone.
I will message you with some more information
ml66uk mrsmop
Posted
The second link should be as follows:
https://patient.info/doctor/bullous-pemphigoid-pro
mrsmop ml66uk
Posted
Thank you! I don't know why it changed when I copied & pasted the second link
ptolemy habib41841
Posted
I notice she is taking Betamethasone. A biopsy can be taken. It can go into remission after some years.