Bullous disorders Flashcards
How would you investigate contact dermatitis?
Patch testing
How would you investigate autoimmune blistering?
Biopsy with IMF
Does bullous pemphigoid or pemphigus vulgaris involve the mouth?
Pemphigus vulgaris
Which antibodies in bullous pemphigoid? And what are they directed against?
Linear IgG, directed at hemidesmosomes in the basement membrane
Treatment for localised bullous pemphigoid
High potent topical steroids
Treatment for generalised bullous pemphigoid
Systemic steroids
Tetracycline
Methotrexate
Prognosis of bullous pemphigoid?
Chronic self-limiting course
Most patients achieve remission within 3-6 months
Which blistering disorder tends to be a disease of middle age?
Pemphigus vulgaris
Which blistering disorder is niklosky sign positive?
Pemphigus vulgaris is niklosky sign positive
What antibodies would you see in pemphigus vulgaris and what are they directed against?
IgG directed against intracellular adhesions = CHICKEN WIRE!!
Treatment of local pemphigus vulgaris
Topical steroids
Treatment of systemic pemphigus vulgaris
Prednisolone Azathioprine Dapsone Cyclosporin Plasmapheresis
Pemphigus vulgaris prognosis
The majority remit within 3-6 years. Mortality rate 10-20%
Which sites are commonly involved in dermatitis herpetiformis?
Extensor aspects of elbows and forearms Buttocks Extensor aspects of knees Scapulae Face, scalp
How would you investigate dermatitis herpetiformis?
Biopsy UNINVOLVED SKIN for detection of granular deposits of papillary IgA
If you do intestinal biopsy as well, 2/3rds of patients will have partial or subtotal villous atrophy
