The following case presents a clinical scenario involving a dermatological condition with notable systemic repercussions. This case is particularly relevant for professionals working in Primary Care, as it illustrates how skin manifestations can sometimes signal deeper, multisystem involvement that requires a comprehensive, integrative approach to patient care.
We are dealing with a 55-year-old female patient, who came to the clinic with pre-existing chronic medical conditions that are highly prevalent in the adult population. Her medical history includes essential arterial hypertension, a condition she has been managing for several years, and chronic obstructive pulmonary disease (COPD), a progressive illness that has had a considerable impact on her respiratory function and overall quality of life.
According to her chart, the patient had no known drug or environmental allergies. She reported being a current smoker, consuming approximately 10 cigarettes per day, a habit that has undoubtedly contributed to the progression of her COPD and represents a significant risk factor for multiple comorbidities. Regarding her chronic treatment, she had been taking enalapril, an angiotensin-converting enzyme (ACE) inhibitor, for blood pressure control for the past six years. For her pulmonary condition, she had been using inhaled formoterol, a long-acting beta-agonist (LABA), regularly for two years.
Recently, however, her respiratory symptoms worsened, prompting her pulmonologist to reevaluate her therapeutic regimen. Based on the latest clinical findings and spirometric assessments, the specialist determined that a step-up in her inhalation therapy was necessary. As a result, the decision was made to discontinue formoterol and initiate treatment with a fixed-dose combination of indacaterol and glycopyrronium in the form of inhaled capsules, taken daily. This new medication offers both bronchodilation and anticholinergic action, aimed at achieving better symptom control and improving the patient’s pulmonary function and exercise tolerance.
The changes in her treatment regimen, coupled with her underlying conditions, would soon be connected to a dermatological issue that emerged unexpectedly — a reminder of the intricate interplay between systemic disease, pharmacological interventions, and skin health.