Autoimmune Skin Disorder - Bullous Pemphigoid

Question 1

What is Bullous Pemphigoid?

Answer 1

Autoimmune condition causing sub-epidermal blistering of the skin.

Question 2

What is Bullous Pemphigoid?

Answer 2

Autoimmune condition causing sub-epidermal blistering of the skin.

Question 3

Clinical Features of Bullous Pemphigoid (3).

Answer 3

1. Itchy Deep Tense Blisters Around Flexor Surfaces in Elderly.
2. Blisters Heal Without Scarring.
3. No Mucosal Involvement.

Question 4

Investigation of Bullous Pemphigoid.

Answer 4

Skin Biopsy : Immunofluorescnce : IgG and C3 at Dermoepidermal Junction.

Question 5

Management of Bullous Pemphigoid (3).

Answer 5

1. Referral to Dermatology.
2. Oral Corticosteroids - Mainstay.
3. Other : Topical Corticosteroids, Immunosuppressants and Antibiotics.

Question 6

Pathophysiology of Bullous Pempigoid.

Answer 6

Type II Hypersensitivity Reaction : Autoantibodies (against hemidesmosomal proteins BP180 and BP230) deposited on the Basement Membrane.

Question 7

Clinical Features of Pemphigus Vulgaris.

Answer 7

1. Fragile Superficial Blisters that Rupture Easily and Undergo De-Squamation.
2. Nikolsky Sign is positive.
3. Oral Mucosa is almost always affected.

Question 8

Pathophysiology of Pemphigus Vulgaris.

Answer 8

Autoimmune condition where there is deposition of IgG autoantibodies (Desmoglein 3) within the epidermis - binding to desmosomes between keratinocytes and cleaving them allowing cells to separate and blisters to form.

Question 9

Investigations of Pemphigus Vulgaris.

Answer 9

Diagnosis - Skin Biopsy and Immunofluorescence : Deposition of IgG Auto-Antibodies within Epidermis.

Question 10

Management of Pemphigus Vulgaris.

Answer 10

Oral Corticosteroids to prevent death - not to cure disease.

Question 11

What is Nikolsky’s Sign?

Answer 11

Spread of bull following application of horizontal tangential pressure to the skin.

Question 12

Clinical Features of Bullous Pemphigoid (3).

Answer 12

1. Itchy Deep Tense Blisters Around Flexor Surfaces in Elderly.
2. Blisters Heal Without Scarring.
3. No Mucosal Involvement.

Question 13

Investigation of Bullous Pemphigoid.

Answer 13

Skin Biopsy : Immunofluorescnce : IgG and C3 at Dermoepidermal Junction.

Question 14

Management of Bullous Pemphigoid (3).

Answer 14

1. Referral to Dermatology.
2. Oral Corticosteroids - Mainstay.
3. Other : Topical Corticosteroids, Immunosuppressants and Antibiotics.

Question 15

Pathophysiology of Bullous Pempigoid.

Answer 15

Type II Hypersensitivity Reaction : Autoantibodies (against hemidesmosomal proteins BP180 and BP230) deposited on the Basement Membrane.

Question 16

Clinical Features of Pemphigus Vulgaris.

Answer 16

1. Fragile Superficial Blisters that Rupture Easily and Undergo De-Squamation.
2. Nikolsky Sign is positive.
3. Oral Mucosa is almost always affected.

Question 17

Pathophysiology of Pemphigus Vulgaris.

Answer 17

Autoimmune condition where there is deposition of IgG autoantibodies (Desmoglein 3) within the epidermis - binding to desmosomes between keratinocytes and cleaving them allowing cells to separate and blisters to form.

Question 18

Investigations of Pemphigus Vulgaris.

Answer 18

Diagnosis - Skin Biopsy and Immunofluorescence : Deposition of IgG Auto-Antibodies within Epidermis.

Question 19

Management of Pemphigus Vulgaris.

Answer 19

Oral Corticosteroids to prevent death - not to cure disease.

Question 20

What is Nikolsky’s Sign?

Answer 20

Spread of bull following application of horizontal tangential pressure to the skin.