Ch 9 Bullous Diseases Flashcards
Subcorneal Bullous Diseases
-SSS, Impetigo, Miliaria
Intraepidermal
- Viral/Herpes
- Pemphigus Vulgaris
- Acute Eczema
- Miliaria Rubra
- Incontentia Pigmentii
Subdermal
- Bullous Pemphigoid
- Linear IgA
- Dermatitis Herpetiformis
- Bullous LE
- Cicatrical Pemphigoid
- Bullous EM
- PCT
- TEN
- EB
- Other bullous diseases
Pemphigus Vulgaris types
- Pemphigus Vulgaris
- Pemphigus Vegitans (folds, heaped up, less serious)
- Desmoglein 3
- HLA-2, Indian, Jews, Meds
- More severe
Superficial Pemphigus
- Generalized Foliaceous
- Localized erythematous
- Desmoglein 1
Drug Induced
-Penicillamine no Ab
Paraneoplastic
- Thymoma
- Castelmans
- Lymphoma
Pemphigus Vulgaris
- Mucous Membrane Involvment
- Desmoglein 3
- Serum Ab
Pemphigus Vulgaris Treatment
-High Dose steroids increase desomogleins and decrease Ab
Subcorneal Pustular Dermaotosis
often IgA to intercellular Ag
Transient Acantholytic Dermatitis (Grover’s)
-Itchy vesicles in sun damaged skin
-Acantholysis
Middle aged men
Bullous Pemphigoid Cause
- Subepidermal blister
- Ab to BP-230 (hemi to keratin)
- BP-180 (hemi to LL)
BP Histology
-IgG and C3 at BM
Eospinphils
BP Presentation
-Elderly with itchy tense blood filled vesicles common on flexures
BP Tx
- Minimal steroids, can use topical
- Tetracyclins, Niacin
Herpes Gestationalis
-Linear C3 at BM with minimal Ig
Linear IgA
- IgA at BM with C3
- Tx with dapsone
Cicatrical Pemphigoid
- Lesions generally occur only on the eyes and mucous membranes, minimal skin involvment
- Ab to laminin 5
Dermatitis Herpetiformis
IgA and C3 at BM
- Treat with Dapsone
- Bx both lesional and non lesional skin
- Itchy vesicles on extensors and buttocks
- Check G6PD
- HLADR3, DQW2
Other subepi
DM related
- Bullous LE
- PCT
- Most others
TEN
-Drugs: Sulpha, Siezures, allopurinaol, GVHD, AIDS
EB Simplex
- AD to Keratin 5/14
- Blisters occur above basal layer leading to minimal scarring an intraepidermal lysis
Junctional EB
- AR to lamina lucidum/BP180
- Rare, deadly early
Dystrophic EB
- Mutations in collagen 7
- AD leads to milia and scarring
- AR - Severe blisters, scarring, contractoins
Acquired
- Ab to lamina lucida
- Dermal split blisters
