4th Year Bullous Disorders Flashcards
nikolsky’s sign in bullous pemphigus
+ve (rotational force causes bursting of blisters)
what causes bullous pemphigus?
IgG attacks desmoglein-3 and 1 in desmosomes
what level are the blisters in bullous pemphigus?
intra-epidermal
immunoflurosence of bullous pemphigus
chicken wire patterns
management of bullous pemphigus
local steroids
topical anaesthetics
good oral hygiene
FIRST LINE= oral steroids (prednisolone)
systemic therapies e.g. azathioprine, dapsone, ciclosporin, plasmapheresis, rituximab
how long can bullous pemphigus take to get better?
3-6 years
what level are the blisters in bullous pemphigoid?
sub-epidermal
nikolsky sign in bullous pemphigoid?
-ve
what causes bullous pemphigoid?
IgG attacks hemidesmosomes at the basement membrane result in local complement activation and tissue damage
what bit of the skin do you biopsy in bullous disorder?
pre-blister bit
immunofluorescence of bullous pemphigoid
uninterrupted DEJ band in green
management of bullous pemphigoid
local potent steorids
oral steroids
steroid sparing agents (tetracycline, azathioprine, dapsone, ciclosporin)
biologics
what layers are the blisters in dermatitis herpetiformis?
sub-epidermal
where does the rash of dermatitis herptiformis form?
extensor surfaces
what causes dermatitis herpetiformis?
peridermal transglutaminase attacks papillary dermis by IgA
