Bullous Disease Flashcards
Give the main causes of blisters or bullae on the skin
Trauma - burns, friction, insect bite
Infection - bullous impetigo, bullous cellulitis, ezcema herpeticum, herpes zoster, cocksakie
Dermatitis- acute dermatitis, pomphylix
Drug reactions - SJS, TEN, erythema multiform
Autoimmune - Pemphigus, Pemphigoid, Dermatitis herpatiformis
Porphyria
autoantibodies affect which structure in bullous pemphigoid
IgG against hemidesmosomes
autoantibodies affect which structure in pemphigus
Ig G against desmosomes
appearance of BP on immunofluoresence
linear deposition of IgG at BM
appearance of pemphigus on immunofluoresence
chickenwire deposition of IgG
describe the main difference in the types of blisters in BP and pemphigus
BP - subepirdermal blisters, tense
pemphigus - intraepidermal blisters - burst leaving erosions
in which bullous condition is nikolskys sign negative
BP
positive in SJS, TEN, pemphigus
treatment of BP
- localised - potent topical steroid
2 .generalised - systemic steroid - 40-80mg for two weeks
- tetracycline, methotrexate
treatment of pemphigus
- Local - topical steroid, topical anaesthetic
- Systemic - in principle high dose steroid + high dose immunosuppressive e.g. dexamethasone + cyclophosphamide
others immumnosuppresives (azathioprine, dapsone, cyclosporin)
3rd line treatments - plasmapheresis, rituximab
what is dermatitisis hepetiformis associated with
coeliac disease (personal or family history)
antibody associated with DH is
anti tissue tranglutaminase (IgA)
what type of blisters occur in DH
sub epidermal (+intra epidermal IGA depositiion)
treatment of DH
gluten free diet
medications - responds well to dapsone
others - tetracycline, sulphapydradin, sulphamethoxypyradozine)
