Blistering disorders

Question 1

What is bullous pemphigoid?

Answer 1

A blistering skin disorder which usually affects the elderly

Question 2

What is the cause of bullous pemphigoid?

Answer 2

Auto-antibodies against antigens between the epidermis and dermis cause a sub-epidermal split in the skin.

Question 3

What is the presentation of bullous pemphigoid?

Answer 3

Tense, fluid filled blisters on an erythematous base
Lesions are often itchy
May be preceded by a non specific itchy rash
Usually affects the trunk and the limbs (mucosal involvement is less common)

Question 4

What is the management of bullous pemphigoid?

Answer 4

General measures- wound dressings where required, monitor for signs of infections

Topical therapies for localised disease- topical steroids

Oral therapies for widespread disease- oral steroids, combination of oral tetracycline and nicotinamide, immunosuppressive agents- azathioprine, mycophenolate mofetil, methotrexate, other

Question 5

What is pemphigus vulgaris?

Answer 5

A blistering skin disorder which usually affects the middle aged

Question 6

What is the cause of pemphigus vulgaris?

Answer 6

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

Question 7

What is the presentation of pemphigus vulgaris?

Answer 7

Flaccid, easily ruptured blisters forming erosions and crusts
Lesions are often painful
Usually affect the mucosal areas (Can precede skin involvement)

Question 8

How do you treat pemphigus vulgaris?

Answer 8

General measures- if oral mucosa is involved then good oral care is needed
Monitor for signs of infection where needed
Wound dressings where required

Oral therapies- high dose oral steroids, immunosuppressive agents eg: methotrexate, azathioprine, cyclophosphamide, mycophenolate mofetil, other

Question 9

What causes blisters?

Answer 9

Trauma
Infections
Drugs
AutoAntibodies
Genetic diseases