Blistering Skin Disorders Flashcards
How can blistering skin conditions be divided?
- Immunobullous diseases
- Blistering skin infections
- Other
What are some examples of immunobullous diseases?
- Bullous pemphigoid
- Pemphigus vulgaris
Give examples of blistering skin infections
- Herpes simplex
- Bullous impetigo
What is an example of an ‘other’ blistering skin condition?
Porphyria cutanea tarda
What does the fragility of blisters depend upon?
The level of split within the skin
What are two levels at which the skin can split to form a blister?
- Intra-epidermal
- Sub-epidermal
What is an intra-epidermal skin split?
A split within the epidermis
What is a sub-epidermal skin split?
A split between the dermis and epidermis
Which type of skin split makes for more fragile bilsters?
Intra-epidermal split
What are some of the more common causes of blisters?
- Impetigo
- Hepres simplex
- Herpes zoster
- Acute contact dermatitis
- Pompholyx
- Burns
What is pompholyx?
Vesicular eczema of the hands and feet
What does the rest of this deck concern?
Immunobullous diseases
What is bullous pemphigoid?
A blistering skin disorder which usually affects the elderly
What is the underlying pathology in bullous pemphigoid?
Autoantibodies against antigens between the epidermis and dermis causing a sub-epidermal split in the skin
What is the main presenting symtpom in bullous pemphigoid?
Tense, fluid filled blisters on an erythematous base
Are bullous pemphigoid lesions itchy?
Often can be
What may precede the blisters of bullous pemphigoid?
A non-specific itchy rash
Where does bullous pemphigoid usually affect?
The trunks and limbs
What general measures shoudl be taken to manage bullous pemphigoid?
- Wound dressings
- Monitor for signs of infection
How should localised bullous pemphigoid be managed?
Topical steroids
How can widespread bullous pemphigoid be managed?
- Oral steroids
- Oral tetracycline and nicotinamide
- Immunosuppressive agents
What immunosuppressive agents can be used to manage widespread bullous pemphigoid?
- Azathioprine
- Mycophenolate mofetil
- Methotrexate
What is pemphigus vulgaris?
A blistering skin condition which usually affect the middle-aged
What is the underlying pathophysiology of pemphigus vulgaris?
Autoantibodies against antigens within the epidermis causing an intra-epidermal split in the skin
What is the main presenting symptom of pemphigus vulgaris?
Flaccid, painful, easily ruptured blisters forming erosion and crusts
What does pemphigus vulgaris causes alongside (and sometimes preceding) skin lesions?
Mucosal lesions
What are the general measures for managing pemphigus vulgaris?
- Wound dressings if required
- Monitor for infection
- Good oral care (if oral lesions)
What oral therapies can be used to manage pemphigus vulgaris?
- High-dose oral steroids
- Immunosuppressive agents
What immunosuppressive agents can be used in pemphigus vulgaris?
- Methotrexate
- Azathioprine
- Cyclophosphamide
- Mycophenolate mofetil
