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BDS4 > OM- Vesiculobullous Diseases > Flashcards

OM- Vesiculobullous Diseases Flashcards

1
Q

Type 1 hypersensitivity cell mediators and examples of conditions

A

IgE
Asthma,anaphylaxis

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2
Q

Type 2 hypersensitivity cell mediators and examples of conditions

A

IgG+IgM
Pemphigus vulgaris
Mucous membrane pemphigoid

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3
Q

Type 3 hypersensitivity cell mediators and examples of conditions

A

IgG,C3,C4
Erythema multiforme, RA,SLE

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4
Q

Type 4 hypersensitivity cell mediators and examples of conditions

A

T cells
Coeliac disease, MS

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5
Q

Why can certain immunological skin diseases also affect oral mucosa

A

Skin and oral/genital mucosa share many common antigens and epitopes

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6
Q

Vesicobullous conditions- lab testing for diagnosis

A

Direct immunofluorescence

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7
Q

Vesicobullous conditions- lab testing for monitoring

A

Indirect immunofluorescence

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8
Q

Vesicobullous conditions examples

A

Erythema multiforme
Pemphigus
Pemphigoid
Angina bullosa haemorrhagica

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9
Q

What is erythema multiforme?

A

Spectrum disorder of immunogenic related skin and mucosa ulceration

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10
Q

Aetiology of erythema multiforme

A

Drugs, herpes simplex, mycoplasma

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11
Q

Erythema multiforme management

A

Steroids and aciclovir- high dose prednisolone
Prophylactic aciclover- if recurrent
Remain hydrated
Analgesics
Allergy test

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12
Q

Angina bullosa haemorrhagica presentation

A

Blood filled tight blister- trauma?
Commonly buccal/palatal/oropharynx
Mostly asymptomatic until burst

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13
Q

Angina bullosa haemorrhagica tx?

A

No tx
CHX MW if symptomatic
Reassure pt-benign

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14
Q

Types of pemphigoid

A

Bullous pemphigoid- skin
Mucous membrane pemphigoid- all mucous membrane- eye,genital,oral
Cicatricial pemphigoid- mucosal with scarring

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15
Q

Mucous membrane pemphigoid investigations

A

Direct immunofluorescence- Linear staining along basement membrane
C3+IgG found,sometimes IgA
Histological- Sub epithelial split- epithelial/connective tissue junction
Hemi-desmosomes involved at basement membrane - inhibit proteins BP180+B230
Nikolsky sign- positive for all pemphigoid except bullous

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16
Q

Mucous membrane pemphigoid presentation

A

Intact bullae-days
Desquamative gingivitis
Commonly palate/gingiva
Rarely buccal/tongue

17
Q

MMP management

A

Steroids
Immune modulators- azathioprine,mycophenolate

18
Q

Pemphigus vulgaris- investigations

A

Direct immunofluorescence- basket weave IgG around epithelial cells
Histological- supra-basal cleft, intraepithelial bullae, tzank cells
Nikolsky sign- positive

19
Q

Pemphigus vulgaris presentation

A

Ruptured bullae- minutes
Uncommonly desquamative gingivitis
Palate, gingiva, buccal, tongue, lips

20
Q

Pemphigus vulgaris management

A

Steroids
Immune modulators- azathioprine, mycophenolate

BDS4 (50 decks)

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