Blistering Skin Conditions Flashcards
Clinical features of an intra-epidermal blister
Thin roof so burst easily
Name of an intra-epidermal blister
Pemphigus
Name of a sub-epidermal blister
Pemphigoid
Clinical feature of a sub-epidermal blister
Thick roof so more likely to stay intact
What is a bullous pemphigoid
Subepidermal blister caused by an autoimmune reaction
When does bullous pemohigoid usually present
> 60
Associations with bullous pemphigoid
Neurological disease: stroke, dementia, Parkinson’s
Internal malignancy
Autoimmune diseases
Name some drugs that can cause bullous pemphigoid
Diuretics
Analgesics
Antibiotics
Potassium iodide
Good
Captopril
Pathophysiology of bullous pemphigoid
IgG reacts with the major or minor antigen of the hemidesmosomes anchoring basal cells to the basement membrane
Compliment activation causes interruption of the DEJ and the formation of a subepidermal blister
What kind of hypersensitivity reaction is bullous pemphigoid
Type 2
Symptoms of bullous pemphigoid
Pruritus
Well demarcated erythematous plaques before the blisters
Large tense extremely itchy blisters
Nikolskys sign
Lateral pressure on the skin next to the blister causes it to extend
Will bullous pemphigoid be nikolsky sign positive
NO - negative
Histology of bullous pemphigoid
Subepidermal blisters with inflammatory infiltrates
Immunofluorescence on bullous pemphigoid
IgG and complement deposited around the basal membrane
Local management of bullous pemphigoid
Prednisolone