A IMUNOSSUPRESSÃO EM UM CONTEXTO DE INFECÇÃO PELO SARS-COV-2

Introduction: pemphigus are autoimmune bullous diseases, rare, of chronic evolution, potentially fatal. Treatment should be done with the use of immunosuppressants. COVID-19 is an infectious pulmonary syndrome caused by the new coronavirus 2019 and among the mortality risk factors immunosuppression stands out. Objective: to highlight the challenges in the management of pemphigus vulgaris in a pandemic context of COVID-19. Case description: A 64-year-old female patient was referred to Hospital Escola Alvaro Alvim in Campos dos Goytacazes, Rio de Janeiro, for investigation of bullous lesions distributed throughout the body with signs of associated secondary infection. Histopathological diagnosis of pemphigus vulgaris and treatment with corticosteroids and systemic antibiotics were performed. During hospitalization, the patient was infected by SARS-CoV-2, evolving with severity, requiring even intensive support. However, despite treatment measures, she died. Discussion: in the context of the COVID-19 pandemic, the treatment of moderate-severe pemphigus represents a challenge for dermatologists, since the use of immunosuppressive drugs is an important risk factor for infection and the severity of the disease caused by this virus . Conclusion: although the use of corticosteroids in the treatment of moderate-severe case pemphigus vulgaris was performed with caution, the patient envolved whit an infectious condition by SARS-CoV-2, which culminated in death. This case becomes relevant until sufficient experience is available to guide therapeutic decision-making.