Chapter 54 - Bullous Pemphigoid

Question 1

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Subepidermal blister, eosinophil predominant infiltrate, with neutrophils, lymphocytes, and monocytes and macrophages

Answer 1

Bullous Pemphigoid

Question 2

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Nikolsky sign (−)

Answer 2

Bullous Pemphigoid

Question 3

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Asboe-Hansen sign (−)

Answer 3

Bullous Pemphigoid

Question 4

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Urticarial lesions precede tense bullae

Answer 4

Bullous Pemphigoid

Question 5

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Mucous membrane lesions present in ~10%

Answer 5

Bullous Pemphigoid

Question 6

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

BPAg1 (230-kDa) or BPAg2 (180-kDa) or type XVII collagen

Answer 6

Bullous Pemphigoid

Question 7

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

DIF IgG in basement membrane

Answer 7

Bullous Pemphigoid

Question 8

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Waxing and waning course, occasional spontaneous remission

Answer 8

Bullous Pemphigoid

Question 9

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Suprabasal blister with acantholysis; characteristic “row of tombstones”

Answer 9

Pemphigus Vulgaris

Question 10

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Nikolsky sign (+)

Answer 10

Pemphigus Vulgaris

Question 11

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Asboe-Hansen sign (+)

Answer 11

Pemphigus Vulgaris

Question 12

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Flaccid blister on any skin surface; erosions most commonly observed

Answer 12

Pemphigus Vulgaris

Question 13

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Mucous membrane lesions presenting sign for majority of patients

Answer 13

Pemphigus Vulgaris

Question 14

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Desmoglein 3 (130 kDa); desmoglein 1 (160 kDa)

Answer 14

Pemphigus Vulgaris

Question 15

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

DIF IgG in intercellular pattern

Answer 15

Pemphigus Vulgaris

Question 16

TABLE 54-1
Comparison of Bullous Pemphigoid and Pemphigus Vulgaris

Fatal if untreated

Answer 16

Pemphigus Vulgaris

Question 17

TABLE 54-3
Treatments for Bullous Pemphigoid

Corticosteroids
(2)

Answer 17

High-potency topical steroids
Prednisone

Question 18

TABLE 54-3
Treatments for Bullous Pemphigoid

Other Immunosuppressive Agents
(3)

Answer 18

Azathioprine
Mycophenolate mofetil
Methotrexate

Question 19

TABLE 54-3
Treatments for Bullous Pemphigoid

Modulators of Antibody Levels
(2)

Answer 19

Intravenous gammaglobulin
Plasmapheresis

Question 20

TABLE 54-3
Treatments for Bullous Pemphigoid

Other
(3)

Answer 20

Tetracycline or erythromycin and nicotinamide
Dapsone
Omalizumab

Question 21

TABLE 54-3
Treatments for Bullous Pemphigoid

B-Cell Depletion
(1)

Answer 21

Rituximab