A/I Blistering Disorders

Question 1

types of herpes viruses and diseases

Answer 1

HSV1 : fever blister
HSV2: genital herpes
VZV (varicella zoster): chicken pox
VZV (herpes zoster): shingles

Question 2

herpes simplex virus 1 clinical features

Answer 2

first: painful vesicles on labial mucosa, maybe fever. Oral gingivostomatisis
recurrent: local grouped vesicles on eryth base, orolabial

Question 3

herpes simplex virus 2 clinical features

Answer 3

genital herpes.

primary: bilat erosions, inguinal LAD. Rarely w aseptic meningitis
recurrent: grouped erosions. shorter the second time away

Question 4

properties of varicella zoster virus

Answer 4

chicken pox. Uncommon now bc vax. Incubates 10-21 days. contagious 4 days before, 5 days after. Resp transmission

Question 5

classic lesion of VZV

Answer 5

teardrop vesicle on eryth base at different stages

Question 6

teardrop

Answer 6

classic chicken pox

guttate psoriasis

Question 7

possible complications of VZV (varicella zoster)

Answer 7

• varicella or bact PNA
• neuro-cerebellar ataxia, enceph
• asymp myocarditis and hepatitis in kids
• Reye syndrome

Question 8

Reye syndrome

Answer 8

Varicella, hepatitis, acute encephalopathy when symptoms of varicella (chicken pox) are tx w aspirin in kids

Question 9

Herpes zoster

Answer 9

caused by react of VZV. Unilat in dermatomal distrib, pain precedes lesions.

Question 10

VZV herpes zoster is latent where

Answer 10

sensory DRG

Question 11

VZV herpes zoster lesions

Answer 11

papules and plaques –> blisters

Question 12

Extra risk in VZV herpes zoster

Answer 12

dissemination in elderly, immunocomp pts

Question 13

tx HSV and VZV

Answer 13

acyclovir, valacyclovir

Dose depends on active lesions vs suppression, immunosupp, etc.

Question 14

Bullouso pemphigoid key features

Answer 14

tense bullae on urticarial (wheal) base

- could have preceding urticarial phase

Question 15

who gets bullous pemphigoid

Answer 15

65-75 yo

Question 16

bullous pemphigoid microscopic cause

Answer 16

linear IgG and C3 at dermoepidermal jn: Abs to BP230 and BP180 (Col XVIIa) Ag at the jn

Question 17

tx of bullous pemphigoid

Answer 17

topical steroids
systemic steroids
TCN/niacinamide
mycophenolate mofetil

Question 18

pemphigus vulgaris key features

Answer 18

flaccid bullae
+nikolsky
chronic
often mucosal involvement

Question 19

who suffers from pemphigus vulgaris

Answer 19

40-50 yo

Question 20

cause of pemphigus vulgaris

Answer 20

Abs vs desmoglein 3, 1
“chicken wire” in epid
Genetics, drug-induced (penicillamine), or neoplastic

Question 21

tx of pemphigous vulgaris

Answer 21

oral steroids
mycophenolate mofetil
azathiprine
rituximab

Question 22

pemphigus foliaceus key features

Answer 22

superficial pemphigus
scaly crusts like cornflakes
rare mucus involvement
not systemically III

Question 23

pempigus foliaceus causes

Answer 23

Abs vs desmoglein I

Question 24

tx pemphigus foliaceus

Answer 24

steroids
mycophenolate mofetil
dapsone
antimalarials

Question 25

linear IgA bullous dermatosis key features

Answer 25

tense bullae in rosette, string of pearls

Question 26

linear IgA bullous dermatosis 2 forms

Answer 26

adult form: LABD. Could be vancomycin-induced

Pediatric: chronic bullous dis of childhood (CBDC)

Question 27

histology of linear IgA bullous dermatosis

Answer 27

subepidermal bulla w neuts

linear IgA at derm/epid jn

Question 28

Dermatitis herpetiformis defn

Answer 28

A/I bullous disorder assoc w gluten-sensitive enteropathy

Question 29

key features of dermatitis herpetiformis

Answer 29

pruritic vesicles on extensor surfaces

Question 30

dermatitis herpetiformis histology

Answer 30

subepidermal vesicles w neuts

granular IgA at dermal papillae

Question 31

tx dermatitis herpetiformis

Answer 31

dapsone

gluten free diet!