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 clinicians gain a greater understanding into the pathogenesis of these diseases, more specific molecular-targeted treatments will most likely become available.

译文

:本文讨论了老年人口中的主要水疱病。免疫和非免疫介导的水疱性疾病的诊断都可以通过组织学和免疫病理学研究得到证实。各种更特异性的血清学检测也可用于确认自身免疫性水疱病的诊断。这些技术有助于诊断并允许早期治疗。起泡性疾病的治疗包括局部治疗和全身治疗。局部治疗涉及局部护理,包括以下措施:预防创伤;将水泡浸泡在防腐剂(高锰酸钾或亚乙酸铝)溶液中;局部和病灶内糖皮质激素;以及预防和早期治疗局部或全身性抗生素的感染。已被证明是有益的常规口服全身疗法包括全身性皮质类固醇,抗炎药和免疫抑制剂。由于老年人更容易出现这些全身性药物的副作用,因此至关重要的是,必须进行常规的血液学检查并进行监测,直到停止治疗为止。最近,事实证明,较新的替代治疗方式在对常规口服全身用药无反应或产生多种副作用的患者中很成功。总而言之,随着临床医生对这些疾病的发病机理有了更深入的了解,更有可能使用更具体的针对分子的治疗方法。

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