[24] Blistering Skin Disorders Flashcards

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1
Q

How can blistering skin conditions be divided?

A
  • Immunobullous diseases
  • Blistering skin infections
  • Other
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2
Q

What are some examples of immunobullous diseases?

A
  • Bullous pemphigoid
  • Pemphigus vulgaris
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3
Q

Give examples of blistering skin infections

A
  • Herpes simplex
  • Bullous impetigo
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4
Q

What is an example of an ‘other’ blistering skin condition?

A

Porphyria cutanea tarda

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5
Q

What does the fragility of blisters depend upon?

A

The level of split within the skin

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6
Q

What are two levels at which the skin can split to form a blister?

A
  • Intra-epidermal
  • Sub-epidermal
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7
Q

What is an intra-epidermal skin split?

A

A split within the epidermis

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8
Q

What is a sub-epidermal skin split?

A

A split between the dermis and epidermis

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9
Q

Which type of skin split makes for more fragile bilsters?

A

Intra-epidermal split

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10
Q

What are some of the more common causes of blisters?

A
  • Impetigo
  • Hepres simplex
  • Herpes zoster
  • Acute contact dermatitis
  • Pompholyx
  • Burns
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11
Q

What is pompholyx?

A

Vesicular eczema of the hands and feet

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12
Q

What does the rest of this deck concern?

A

Immunobullous diseases

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13
Q

What is bullous pemphigoid?

A

A blistering skin disorder which usually affects the elderly

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14
Q

What is the underlying pathology in bullous pemphigoid?

A

Autoantibodies against antigens between the epidermis and dermis causing a sub-epidermal split in the skin

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15
Q

What is the main presenting symtpom in bullous pemphigoid?

A

Tense, fluid filled blisters on an erythematous base

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16
Q

Are bullous pemphigoid lesions itchy?

A

Often can be

17
Q

What may precede the blisters of bullous pemphigoid?

A

A non-specific itchy rash

18
Q

Where does bullous pemphigoid usually affect?

A

The trunks and limbs

19
Q

What general measures shoudl be taken to manage bullous pemphigoid?

A
  • Wound dressings
  • Monitor for signs of infection
20
Q

How should localised bullous pemphigoid be managed?

A

Topical steroids

21
Q

How can widespread bullous pemphigoid be managed?

A
  • Oral steroids
  • Oral tetracycline and nicotinamide
  • Immunosuppressive agents
22
Q

What immunosuppressive agents can be used to manage widespread bullous pemphigoid?

A
  • Azathioprine
  • Mycophenolate mofetil
  • Methotrexate
23
Q

What is pemphigus vulgaris?

A

A blistering skin condition which usually affect the middle-aged

24
Q

What is the underlying pathophysiology of pemphigus vulgaris?

A

Autoantibodies against antigens within the epidermis causing an intra-epidermal split in the skin

25
Q

What is the main presenting symptom of pemphigus vulgaris?

A

Flaccid, painful, easily ruptured blisters forming erosion and crusts

26
Q

What does pemphigus vulgaris causes alongside (and sometimes preceding) skin lesions?

A

Mucosal lesions

27
Q

What are the general measures for managing pemphigus vulgaris?

A
  • Wound dressings if required
  • Monitor for infection
  • Good oral care (if oral lesions)
28
Q

What oral therapies can be used to manage pemphigus vulgaris?

A
  • High-dose oral steroids
  • Immunosuppressive agents
29
Q

What immunosuppressive agents can be used in pemphigus vulgaris?

A
  • Methotrexate
  • Azathioprine
  • Cyclophosphamide
  • Mycophenolate mofetil