ABSTRACT
Bullous pemphigoid (BP) is a complex autoimmune blistering disease with an increased incidence in the comorbid population, particularly among older adults. The occurrence of drug-induced BP is associated with an underlying genetic predisposition, triggering an enhanced immune response, the formation of autoantibodies, and alterations in antigenic properties within the basement membrane zone. With over 90 identified drugs capable of precipitating BP, we present the case of an 87-year-old woman with comorbidities who experienced a medication change from losartan to sacubitril/valsartan. Three months later, erythematous lesions appeared on her lower limbs, progressing to a generalized rash accompanied by itching. Over the following month, these lesions evolved into tense blisters with serous content and intense pain. Suspecting the medication switch to sacubitril/valsartan as the cause, the drug was discontinued, and immunomodulatory treatment was initiated, resulting in a notable improvement in the lesions.
ABSTRACT
INTRODUCTION: Multiple psychosocial interventions for bipolar disorder have been proposed in recent years. Therefore, we consider that a critical review of empirically validated models would be useful. METHODS: A review of the literature was conducted in Medline/PubMed for articles published during 2000-2010 that respond to the combination of "bipolar disorder" with the following key words: "psychosocial intervention", "psychoeducational intervention" and "psychotherapy". RESULTS: Cognitive-behavioral, psychoeducational, systematic care models, interpersonal and family therapy interventions were found to be empirically validated. All of them reported significant improvements in therapeutic adherence and in the patients' functionality. CONCLUSIONS: Although there are currently several validated psychosocial interventions for treating bipolar disorder, their efficacy needs to be specified in relation to more precise variables such as clinical type, comorbid disorders, stages or duration of the disease. Taking into account these clinical features would enable a proper selection of the most adequate intervention according to the patient's specific characteristics.
Subject(s)
Bipolar Disorder/therapy , Psychotherapy , Cognitive Behavioral Therapy , Humans , Psychotherapy/methodsABSTRACT
Introducción. En los últimos años han sido propuestas múltiples intervenciones psicosociales para el tratamiento del trastorno bipolar. Una revisión crítica de los modelos validados empíricamente resultaría de utilidad. Método. Se realizó una revisión bibliográfica de artículos publicados en Medline/Pub Med durante los años 2000-2010 que respondieran al cruce de trastorno bipolar con las siguientes palabras claves: "psychosocial intervention","psychoeducational intervention" y "psychotherapy". Resultados. Cuentan con validez empírica intervenciones provenientes de los modelos cognitivo-conductual, psicoeducativo, cuidado sistemático, interpersonal y familiar. Todas ellas dan cuenta de mejoras significativas en la adhesión a las indicaciones terapéuticas y un incremento en la funcionalidad Conclusiones. Si bien se utilizan diversas intervenciones psicosociales validadas para el abordaje del trastorno bipolar, su nivel de eficacia debería precisarse en base a variables más específicas como ser las formas clínicas, tipo de comorbilidad ,fases o duración de la enfermedad. Estas delimitaciones permitirían seleccionar la intervención más adecuada según las características del paciente (AU)
Introduction. Multiple psychosocial interventions for bipolar disorder have been proposed in recent years. Therefore, we consider that a critical review of empirically validated models would be useful. Methods. A review of the literature was conducted in Medline/Pub Med for articles published during 2000-2010that respond to the combination of "bipolar disorder" with the following key words: "psychosocial intervention", "psychoeducational intervention" and "psychotherapy". Results. Cognitive-behavioral, psychoeducational, systematic care models, interpersonal and family therapy interventions were found to be empirically validated. All of them reported significant improvements in therapeutic adherence and in the patients functionality. Conclusions. Although there are currently several validated psychosocial interventions for treating bipolar disorder, their efficacy needs to be specified in relation to more precise variables such as clinical type, comorbid disorders, stages or duration of the disease. Taking into account these clinical features would enable a proper selection of the most adequate intervention according to the patients specific characteristics (AU)
