December 4, 2015 - Vessiculobullous Disease

Question 1

Bullous Pemphigoid

Answer 1

An acute or chronic autoimmune skin disease involving the formation blisters, more appropriately known as bullae, at the space between the epidermis and dermis. Classified as a Type II Hypersensitivity reaction.

Diagnosis is a skin biopsy.

Treatment is steroids (locally or systemically), and systemic antibiotics, or immunosuppressive agents.

Question 2

Pemphigus Vulgaris

Answer 2

Is a chronic blistering skin disease with skin lesions that are rarely pruritic, but often very painful. It is classified as a Class II Hypersensitivity reaction, with the formation of anti-desmosome antibodies.

Often in ages 40-60, particularly in Ashkenazi Jews and Mediterraneans.

Diagnosis is with biopsy.

Treatment is important because mortality is high if untreated. Systemic steroids are used along with immunosuppressive agents to minimize steroid side effects.

Question 3

Dermatitis Herpetiformis

Answer 3

Is a chronic blistering skin condition, characterised by blisters filled with a watery fluid. It is not caused by the herpes virus. Linked to celiac disease.

Associated with HLA-DQ2

Intensely itchy and papules are filled with neutrophils.

Diagnosis is by biopsy.

Treatment is a gluten-free diet, as well as Dapsone and Sulfapyridine.