Skin blisters

Question 1

Name two immunobullous diseases

Answer 1

bullous pemphigoid

bullous pemphigus

Question 2

Name two causes of serious blistering of the skin

Answer 2

drugs
infection
immunobullous disease

Question 3

What is the difference between bullous pemphigoid and pemphigus vulgaris?

Answer 3

bullous pemphigoid (d at the end)- affects deeper layers of skin i.e. between epidermis and dermis, causing intact blister, while pemphigus vulgaris (s at the end) affects more superficial layers, causing split more superficially, therefore no intact blister.

Question 4

What is the pathophysiology of bullous pemphigoid?

Answer 4

autoimmune blistering disease due to auto-abs against hemidesmosomes

Question 5

What is the pathophysiology of pemphigus vulgaris?

Answer 5

autoimmune blistering disease due to auto-abs against desmosomes

Question 6

What is a typical presentation of bullous pemphigoid?

Answer 6

elderly, tense bullae, itchiness

Question 7

Which drugs can precipitate pemphigus vulgaris?

Answer 7

NSAIDs, ACEi, L-dopa

Question 8

Describe a typical presentation of pemphigus vulgaris

Answer 8

younger, large flaccid bullae which rupture easily, mucosa often affected

Question 9

What is the treatment of pemphigus vulgaris?

Answer 9

prednisolone, rituximab

Question 10

In which immunobollous disease is Nikolsky’s sign positive?

Answer 10

If the test result is positive, the very thin top layer of skin will shear off, leaving skin pink and moist, and usually very tender.

Pemphigus vulgaris
TEN