Blistering disorders Flashcards
Blistering skin disorder can be divided into
- Immunobullous disease (bullous pemphigoid, pemphigus vulgaris)
- blistering skin infections (herpes simplex)
- other (poryphria cutanea tarda)
Fragility of blisters depends on
level of split
- intra-epidermal split (within epidermis) –> splits easily
- sub-epidermal split (split between epidermis and dermis) –> less fragile
Common causes of blisters
- impetigo
- insect bites
- herpes simplex infection
- herpes zoster infection
- acute dermatitis
- pomphlox
- burns
Bullous pemphigoid definition
Blistering skin condition which usually effects the elderly
Bullous pemphigoid causes
Autoantibodies against the epidermis and dermis causing a sub-epidermal split in the skin
Clinical features of bullous pemphigoid
- 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 limbs
Management of bullous pemphigoid
General measures – wound dressing where required, monitor for signs of infection
Topical therapies for localised disease – topical steroids
Oral therapies for widespread disease – steroids, combination of oral tetracycline and nicotinamide, immunosuppressive agents (aziathioprine)
Definition of pemphigus vulgaris
A blistering skin disorder which usually affects the middle aged
Cause of pemphigus vulgaris
Autoantibodies against antigens within the epidermis causing an intra-epidermal split in the skin
Clinical features of pemphigus vulgaris
- Flaccid, easily ruptured blisters forming erosions and crusts
- Lesions are often painful
Usually affects the mucosal areas
Management of pemphigus vulgaris
General measures – wound dressings, monitor for signs of infection, good oral care
Oral therapies – high dose oral steroids, immunosuppressive agents (methotrexate, aziathioprine, cylocphosphamide)
