Blistering Conditions Flashcards
Blistering condition with mucosal involvement
Pemphigus vulgaris
Blistering condition withOUT mucosal involvement
Bullous Pemphigoid (Mouth is spared)
Which conditions are immunobullous?
Bullous pemphigoid
Pemphigus vulgaris
7 common conditions causing blisters
Impetigo Herpes zoster virus Herpes simplex virus Insect bites Acute contact dermatitis Pompholyx Burns
Which rare genetic condition involves blistering of the skin?
Epidermolysis bullosa
Describe the prodromal phase of bullous pemphigoid
Pruritic, eczematous, papular, or urticaria-like skin lesions
4 features of lesions in bullous pemphigoid
Tense bulla on an erythematous, urticarial, or noninflammatory base
Numerous + widespread
Symmetrical
Favour flexural extremities, lower trunk, + abdomen.
What happens if a blister bursts in bullous pemphigoid?
Moist eroded crusty areas slowly heal
Leave post-inflammatory hyperpigmentation.
Population commonly affected by bullous pemphigoid
Elderly
Aetiology of bullous pemphigoid
Autoantibodies against antigens between epidermis + dermis causes sub-epidermal split in skin
Dx of bullous pemphigoid
Biopsy
Tx for bullous pemphigoid
Topical clobestol (limited) Prednisolone PO (severe/ widespread) Antihistamines for itch Abx for steroid sparing in long term
Population commonly affected by pemphigus vulgaris
Middle aged
3 features of mucosal involvement pemphigus vulgaris
Oral cavity often initial site (+ most common)
Blisters erode quickly, leave erosions
Painful- difficulty eating, weight loss, + malnutrition.
4 features of skin lesions in pemphigus vulgaris
Flaccid blisters
On normal-appearing or erythematous skin
Rupture easily, painful erosions bleed easily
Palms + soles often spared
Which sign may be seen in pemphigus vulgaris?
Nikolsky sign
elicitation of skin blistering as a result of gentle mechanical pressure on the skin
Ix for pemphigus vulgaris
Biopsy
Tx for mild pemphigus vulgaris
Prednisolone PO +/- Azathioprine PO
Rituximab IV +/- Prednisolone PO
Tx for moderate-severe pemphigus vulgaris
Rituximab IV +/- Prednisolone PO
Prednisolone PO +/- Azathioprine PO (if Rit CI)
3 epidemiological/ aetiological features of dermatitis herpetiformis
Coeliac disease
Often early adulthood
Deposition of IgA in dermis
3 features of presentation in dermatitis herpetiformis
Itchy extensor surfaces
Symmetrically distributed papules + vesicles
Gluten sensitive arthropathy
Ix for dermatitis herpetiformis
Skin biopsy
Tx for dermatitis herpetiformis
GF diet
+/- Abx: Dapsone PO
