Blistering Disorders

Question 1

How are blistering skin disorders divided?

Answer 1

Immunobullous diseases - bullous pemphigoid, pemphigus vulgarisms

Blistering skin infections

Other

Question 2

How does the level of split in the skin affect fragility of the skin?

Answer 2

Intra-epidermal - easily rupture

Sub-epidermal - less fragile

Question 3

What are the common causes of blistering?

Answer 3

Impetigo
Insect bites
Herpes simplex infection
Herpes zoster
Acute contact dermatitis
Pompholyx
Burns

Question 4

What is bullous pemphigoid?

Answer 4

Blistering skin disorder which usually affects the elderly

Caused by autoantibodies against antigens between epidermis and dermis - sub epidermal split in skin

Question 5

How does bullous pemphigoid present?

Answer 5

Tense, fluid filled blisters on erythematous base
Itchy lesions
Preceded by non-specific itchy rash
Usually affect trunk and limbs

Question 6

How is bullous pemphigoid managed?

Answer 6

General measures - wound dressings, monitor for signs of infection
Topical steroids - localised disease
Oral therapies - steroids, combined oral tetracycline and nicotinamide, immunosuppressive agents

Question 7

What is pemphigus vulgaris?

Answer 7

Blistering skin disorder which affects Middle Ages people

Autoantibodies against antigens in epidermis - intra-epidermal split in skin

Question 8

How does pemphigus vulgaris present?

Answer 8

Flaccid easily ruptured blisters forming erosions and crusts
Lesions often painful
Usually affect mucosal areas

Question 9

How is pemphigus vulgaris managed?

Answer 9

General measures

Oral therapies - steroids, immunosuppressive (methotrexate, azathioprine, cyclophosphamide, mycophenolate)