Blisters Flashcards
what is the difference between a vesicle and a bulla
- diameter
what distinguishes erosion from ulcer
- depth
what is the name for a small blister
- vesicle
what is the name for a large blister
- bulla
what is the name for when blisters unroof
- erosion
what is the name for dried transudate
- crust
what does acral mean
- on distal extremities - hands and feet
what does arcuate mean
- in an arc or curve
what does dermatomal mean
- follows distribution of sensory nerve
what does intertriginous mean
- in the body’s folds
what does linear mean
- straight line
_____ is caused by an eruption of latent varicella zoster virus
- herpes zoster
group vesicles on an erythematous base are typical of
- herpes zoster
herpes zoster is usually preceded by
- pain or burning
shingles in the immunocompetent versus HSV
- shingles occurs once - HSV recurs
treatment for shingles
- acyclovir - valacylovir
clues to diagnosis of shingles
- dermatomal eruption - unilateral distribution
grouped vesicles on an erythematous base on the chin and lip are most likely
- herpes simplex
what do the vesicles of herpes simplex look like
- pustular
HSV1 favors what regions
- mouth and nose
HSV2 favors what regions
- genitalia - buttock - thighs
perianal erosions or ulcerations in the immunosuppressed patients are usually _____
- herpes simplex
recurrent ulcers on buttocks or genitals are _____ until proven otherwise
- HSV
what is herpetic whitlow
- form of herpes on the finger
what is Tzanck prep problems
- scrape and microscopic exam - can’t differentiate VZV from HSV
viral culture for HSV can be performed when ____ is present
- fluid
_____ can differentiate HSV 1 and 2 as well as VZV
- direct fluorescent antibody test
_________ determines past exposure but may not directly relate to clinical findings
- HSV antibody detection
_________ is a rapid and sensitive diagnostic test that differentiates HSV1, HSV2, and VZV and is the initial test of choice at UNC
- fluid swab
treatment for HSV
- acyclovir
why don’t we use famciclovir or valacyclovir for HSV treatment their benefit
- more expensive - easier dosing
what presents as very pruritic vesiculopapules on the palms, soles, and sides of the fingers
- dyshidrotic eczema
after healing, dyshidrotic eczema leave behind a mark with a _______ color called ________
- mahogany color - post-inflammatory hyperpigmentation
mainstay of treatment of dyshidrotic eczema
- potent topical steroids
what conditions have vesicles located on the dorsal foot
- contact dermatitis - insect bites
what conditions have vesicles located on the sides of feet and toes
- dyshidrotic eczema
what conditions have vesicles located on the soles
- tinea pedis
what conditions have vesicles located on the balls, heels of foot
- friction blisters
what conditions have vesicles located on the mouth/nose/eyes
- HSV - bullae impetigo
what conditions have vesicles located on the chest and back in a dermatomal pattern
- VZV
what conditions have vesicles located on the fingers
- dyshidrotic eczema - contact dermatitis - herpetic whitlow
what conditions have vesicles located on the arms and legs
- contact dermatitis
what conditions have vesicles located on the genitalia with a bathing suit distribution
- HSV
what conditions have vesicles located on the feet
- dyshidrotic eczema - tinea pedis - allergic contact dermatitis
in which conditions does pain precede onset
- HSV - VZV
in which conditions does itch precede onset
- allergic contact dermatitis - dyshidrotic eczema - VZV
in which conditions does trauma precede onset
- friction blister - pressure ulcer - cryotherapy
in which conditions do you have recurrent blisters
- HSV
what is the primary VZV infection
- chicken pox
buzzword condition for diffuse vesicles on an erythematous base with various stages of healing
- chicken pox
how to diagnose chicken pox
- PCR - DFA - cultura - Tzank
in pemphigus vulgaris, you have autoantibodies to _________ between keratinocytes resulting in ______ bullae and erosions
- desmogleins 1 and 3 - superficial
pemphigus vulgaris is usually seen in which age group
- elderly
pemphigus vulgaris diagnose by
- directly immunofluorescence
pemphigus vulgaris classically has _____ involvement
- oral
autoantibodies to desmoglein 3 and 1 in pemphigus vulgaris form what pattern
- net-like
bullous pemphigoid, you have autoantibodies to _____ resulting in _______ bullae on pruritic, urticarial base
- hemidesmosome - deep, tense
bullous pemphigoid split between which two layers
- basement membrane and basal layer
bullous pemphigoid affects what age
- elderly
bullous pemphigoid which antibodies found with direct immunofluorescence
- BPAG2 antibodies
bullous pemphigoid has what pattern of staining at the basement membrane zone
- linear staining
when would you do a biopsy for direct immunofluorescence test
- autoimmune bullous diseases
bullous impetigo can be diagnosed with
- bacterial culture
