Dermatology: Acquired, Autoimmune Blistering Dermatoses

Question 1

name anatomic location of blisters in bullous pemphigoid vs pemphigus vulgaris

Answer 1

BP: basement membrane zone
PV: intraepidermal

Question 2

name autoantibodies in bullous pemphigoid vs pemphigus vulgaris

Answer 2

BP: anti-bullous pemphigoid
PV: anti-desmoglein; desmoglein is responsible fore keratinocyte adhesion

Question 3

name blister appearance in bullous pemphigoid vs pemphigus vulgaris

Answer 3

BP: firm, stable blisters, may be preceded by urticaria
PV: erosions are more common than intact blisters owing to the lack of keratinocyte adherence

Question 4

name presence of Nikolsky’s sign in bullous pemphigoid vs pemphigus vulgaris

Answer 4

BP: negative
PV:positive

Question 5

name mucosal involvement in bullous pemphigoid vs pemphigus vulgaris

Answer 5

BP:rare
PV:common

Question 6

name pt’s age in bullous pemphigoid vs pemphigus vulgaris

Answer 6

BP: usually >60 yrs of age
PV: usually 40-60 yrs of age

Question 7

name associated medication triggers in bullous pemphigoid vs pemphigus vulgaris

Answer 7

BP: generally idiopathic
PV: ACEIs, penicillamine, phenobarbital, penicillin

Question 8

name mortality associated with bullous pemphigoid vs pemphigus vulgaris

Answer 8

BP: rare and milder course
PV: possible

Question 9

name diagnosis in bullous pemphigoid vs pemphigus vulgaris

Answer 9

BP: clinical features, skin biopsy with immunofluorescence and or ELISA
PV: same as that for bullous BP

Question 10

name treatment for bullous pemphigoid vs pemphigus vulgaris

Answer 10

BP: steroids (prednisone)
PV: high dose steroids (prednisone) + immunomodulatory therapy (IVIG, MMF, rituximab)