Mucocutaneous Disease Flashcards
What is a macule?
Circumscribed flat lesion
Not elevated and not palpable
What is papule?
Circumscribed raised lesion
What is blister?
Fluid filled sac in epithelium or bone
What is vesicle?
Small blister less than 5mm in size
What is bulla?
Large blister >5mm in size
What is erosion?
Marked thinning or partial loss of epithelium - thin covering remains
What is ulcer?
Localised loss of entire thickness of epithelium exposing underlying CT
Examples of autoimmune bullous disease?
Pemphigus
Pemphigoid
Dermatitis herpetiformis
What type of hypersensitivity are autoimmune bullous disease and why?
Type II as antibody mediated and organ specific
What is pemphigus?
Organ specific autoimmune disease targeting skin and oral mucosa
Who more likely to see pemphigus in?
40-60year olds
Male: = female
Are lesions always seen in mouth in pemphigus cases?
Involved most cases
In 50% of cases only site affected
Where in mouth expect to see bulla of pemphigus?
Palate, buccal mucosa and gingival - often short lived
How would expect bulla appear in pemphigus?
Large shallow non-healing ulcer
How expect gingiva to look in pemphigus?
Full thickness inflammation - gingivitis
What clinical test is used in pemphigus?
Nikolsky’s sign
What is Nikolsky’s sign?
Use blunt end of probe (not on blister) to see if underlying bullies problem
What will positive Nikolsky’s sign show?
Skin will shear off
What is pathogenesis of pemphigus?
Have circulating antibodies against binding proteins desmosomes
Autoantibody binds to desmoglein 3 causing acantholysis and formation if intra-epithelial bulla
What bulla do see in pemphigus?
Intra-epithelial
What see histology of pemphigus regarding basement membrane?
Basement membrane is attached to connective tissue
Where see bulla in histology of pemphigus?
Intra-epithelial - see cleft/split supra-basal therefore within epithelial cells
What cells might expect to see in split on pemphigus histology?
Tzank cells