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 News Article 
bullet Blister agony
 Source: Mind Your Body, The Straits Times
Thursday,  11 |  2 | 2010
By Geraldine Ling


A housewife recounts her anxious search for a cure and answers when mysterious painful blisters kept appearing in her mouth and throat. GERALDINE LING reports

For a brief moment 2 1/2 years ago, Mrs Betsy Wee thought that it was time for her to meet her maker.

At the time, a blister on her upper gum had burst into a bloody mess.

Mrs Wee, now 57, was unaware then that she had contracted Pemphigus Vulgaris (PV), a rare blistering skin disorder.

Besides skin blisters, another major symptom is persistent oral blisters which erupt to form painful erosions, like ulcers.

"I didn't understand what was going on. It was so painful. There was a lot of blood when it burst and it had a fishy odour. I was mentally prepared for the end. I cried so hard because I thought I was dying," said the housewife.

Panicking she went to see a gum specialist as she thought she had a gum problem.

Although the burst blister on her gum was the trigger that prompted her to seek medical help, a few other blisters had started appearing a month before, although not all at once. She bore with them all.

Recalling the first blister that appeared, the housewife said: "It was in my throat. I thought I had swallowed a fish bone. I only realised it was a blister when it burst and I felt the pain and smelt the blood.

"I also had a blister on my chest that wouldn t go away for a month.
 
"My teeth were mysteriously stained brown and there was a thick yellow coating on my tongue. My friends thought I had started smoking."

The gum specialist she saw ruled out gingivitis or gum inflammation. She was referred to several dental specialists but they could not figure out the cause of her ailment.

Meanwhile, blisters sprouted on her tongue, on the side of her cheek, back of her mouth and on her chest. "Thankfully they appeared only one at a time. Otherwise, the pain would have been unbearable," she said.

Eating was painful. While she managed to keep to her usual diet of rice and cooked dishes, she had to swallow fast to prevent food from coming into prolonged contact with the blisters.

Finally, an alert doctor spotted a dried up blister on her chest and suggested she see a dermatologist. Taking his advice, Mrs Wee went to see one at Changi General Hospital.

There, a biopsy of one of hr blisters was done. Results confirmed that she had PV.

Despite being diagnosed with the rare disease, Mrs Wee refused to become morose. "A lot of people would ask: "Why me?", but I didn't. I believe that there's a purpose for everything that happens," she said.

She was prescribed an oral steroid, prednisolone, and an immunosuppressive drug, azathioprine.

Due to possible side effects from the oral steroid, she had to be monitored closely. She had to have her liver function, blood glucose, blood pressure I and bone mineral density tested. She needed eye tests too.

Prolonged use of oral steroids can lead to osteoporosis, heightened risk of infections and higher blood pressure.

After a few months, her condition was brought under control and the dosage was gradually reduced.

Mrs Wee is currently still under medication.

Her attending physician, Dr Rachael Teo, an associate consultant at the dermatology department at Changi General Hospital said: "There is currently no cure for PV. Patients often require months to years of oral medication to achieve remission."

Unfortunately, PV was not the last of Mrs Wee's ordeals. In September last year, she discovered that she had a cyst on her right kidney and underwent laparoscopy, or keyhole surgery, to have it removed.

One month later, she went through another operation to ligate her haemorrhoids. This involves a minor procedure where the haemorrhoids are tied off with rubber bands.

Despite all that she has been through, she said: "I'm a positive thinker and I have no regrets. Everything is in God's hands."

lingg@sph.com.sg