Bullous disorders and their treatment

Question 1

Bullous pemphigoiD

Answer 1

Circulating IgG antibodies react with the major and minor hemidesmosomes that anchor the basal cells to the basement membrane. This allows blisters to form in between.
Deep to the epidermis.
Nikolskys sign negative (top layers of the skin don’t slip away when rubbed)

Question 2

PemphiguS

Answer 2

Autoimmune condition where loss of integrity between epidermal cells mean blisters can form.
Superficial- intraepidermal
Nikolskys sign positive (top layers of the skin slip away when rubbed)

Question 3

Nikolsky’s sign

Answer 3

Top layers of skin slip away from the lower layers when slightly rubbed.

Question 4

Pemphigus vulgaris

Answer 4

Fluid filled blisters which rupture to form shallow erosions. May affect the mucosal areas and involves the skin especially the scalp, genitals, axillae and face.

Question 5

Treatment of them:

Answer 5

Pemphigus and pemphigus vulgaris respond to steroids
Bullous pemphigoid- tetracycline
Possibly use other immunosuppressive agents