VBD

Question 1

List examples of cell mediated immune disease

Answer 1

RAU
LP
OFG

Question 2

List examples of antibody mediated disease

Answer 2

Pemphigus
Pemphigoid

Question 3

Describe how a vesicle forms (5)

Answer 3

Autoantibody attack on desmosomes
Loss of cell to cell adhesion
Split in skin
Fills with inflammatory exudate
Vesicle formed (1-2mm)

Question 4

Test for VBD

Answer 4

DIF

Question 5

What can Erythema Multiforme lead to?

Answer 5

Steven Johnson Syndrome

Question 6

Define angina bullosa haemorrhagica

Answer 6

Common oral blood blisters

Question 7

Presentation of angina bullosa haemorrhagica

Answer 7

Rapid onset
Last 1hr then burst
Painless
Usually trauma related
Heal with no scars in a few days

Question 8

What is more serious Pemphigoid or Pemphigus?

Answer 8

Pemphigus (disGUSting)

Question 9

Compare histology of Pemphigoid vs Pemphigus (6)

Answer 9

PEMPHIGOID
- Subepithelial split
- Hemidesmosomes at BM
- Linear stain hugging BM

PEMPHIGUS
- Supraepithelial split
- Desmosomes at BM
- Tzank cells
- Basket weave staining

Question 10

Compare clinical features of Pemphigoid vs Pemphigus

Answer 10

PEMPHIGOID
- Subepithelial bullae
- Thick walled blisters
- Scarring (Symblepharon)

PEMPHIGUS
- Intraepithelial bullae
- Shallow, burst + fatal (dehydration)

Question 11

IF findings for both pemphigus+pemphigoid

Answer 11

C3+igG

Question 12

Tx for Pemphigus/Pemphigoid

Answer 12

Refer - Biopsy+IF
Systemic Steroid - Prednisolone
Systemic Immunemodulator - Azathioprine
CHX for plaque control