Bullous Disorders + Pigmentary Disorders

Question 1

1ry pathological leison in Bullous diseases

Answer 1

Vesicles or blisters

Question 2

Auto antibodies in pemphigous vulgaris

Answer 2

Desmoglein- 1 & 3 ( for integrity of oral mucosa )

Question 3

Cardinal process in pemphigus vulgaris

Answer 3

Split in epidermis
Acantholysis

Question 4

Flaccid bullae with erosion & oral mucosal affection…….

Answer 4

Pemphigus vulgaris

Question 5

Positive Nikolsky sign and Asboe Hansen sign in…….

Answer 5

Pemphigus vulgaris

Question 6

Bullos pemphigoid characterized by …….

Answer 6

Tense bullae

Question 7

Investigation of Bullous diseases show

Answer 7

Pemphigus vulgaris: suprabasal blisters & neutrophilc infiltrate
Bullous pemphigoid: subepidermal blisters & esonphilic infiltrate

Question 8

Immunoflurescence in Bullous Disorders showing…..

Answer 8

• Pemphigus vulgaris : intercellular IGg,C3
• Bullous Pemphigoid : linear deposits along dermoepidermal junction IGg,C3

Question 9

Treatment of pemphigus vulgaris

Answer 9

•Systemic therapy
- oral corticosteroids: prednisolone 60-120 mg/day.
methylprednisolone, IV for 5 days, intralesional triamcinolone acetonide
•Topical therapy
- k permanganate &antibiotic creams
•Oral lesions:
- Topical steroid
•Adjuvant :
1. Immunosuppressive drugs.
2. Anti-inflammatory agents.
3. Immunomodulatory procedure

Question 10

Healing of Bullous pemphigoid by……

Answer 10

hyperpigmentation without scaring.

Question 11

Treatment of Bullous pemphigoid

Answer 11

Localized disease :Potent topical steroid.
• Generalized disease 40-60 mg prednisolone daily.
✓Dapsone 100 mg daily
✓Tetracycline 500 mg 4 times daily.
✓IV immunoglobulin
✓Cyclosporin