Vesicubullous disease Flashcards
what are the 4 main types of vesicubullous disease
pemphigus vulgaris
bullous pemphigoid
dermatitis herpetiformis (DH)
epidermolysis bullosa (EB)
is pemphigus vulgaris a autoimmune disease
yes
is pemphigus vulgaris superficial or deep in comparison to bullous pemphigoid?
which layer does it affect
Superficial = pemphigus vulgariS Deep = bullous pemphigoiD
pemphigus vulgaris affects the epidermis
is pemphigus vulgaris serious
yes it can be fatal
which vesicubullous disease is most common
pemphigus vulgaris
how does pemphigus vulgaris present (3+locations)
painful blisters
burst easily
leaves ulcerated lesions
location - mouth mucosa (plus scalp, axilla, groin, trunk)
what is nikolsky sign
when the top layer of skin slips away form lower layers of skin when rubbed slightly
is nikolsky sign positive or negative in pemphigus vulgaris
positive
when is nikolsky sign negative
in bullous pemphigoid
what is acantholysis
breakdown of intercellular adhesion sites = skin falls apart
does acantholysis happen in pemphigus vulgaris
yes
what is the treatment of pemphigus vulgaris
steroids
topical emollients
topical steroids
prognosis of pemphigus vulgaris
fatal if untreated
which age group does bullous pemphigoid present in
elderly
is bullous pemphigoid superficial or deep in comparison to pemphigus vulgaris?
which layer does it affect
Deep = bullous pemphigoiD Superficial = pemphigus vulgariS
at the De junction
presentation of bullous pemphigoid
itchy but cant burst (too deep)
blistering (occurs after itch)
does acantholysis occur in bullous pemphigoid
no, just in pemphigus vulgaris
what is the pathophysiology of bullous pemphigoid
IgG react with antigens in basal cells = damage occurs
is nikolsky sign negative or positive in bullous pemphigoid
negative - the top layer of skin does NOT slip away when slightly rubbed
treatment of bullous pemphigoid (similar to pemphigus but with something additional)
steroids
tetracycline ANTIBIOTICS (different from pemphigus)
topical emollients
topical steroids
is dermatitis herppetifrormis common or rare
rare
which GI condition is dermatitis herpetiformis strongly associated with
coeliac disease
which antibody is involved in dermatitis herpetiformis
IgA
where does the pathophysiology of dermatitis herpetiformis take place
DE junction
what is the presentation of dermatitis herpetiformis (2 + location)
v itchy lesions on extensor surfaces
GI symptoms - fatigue, bloating, change in bowel habit
location - extensor surfaces eg elbows, knees, buttocks symmetrically
aetiology of epidermolysis bullosa (EB) in children
genetic
aetiology of epidermolysis bullosa (EB) in adults
what is this also known as
autoimmune
EB aquisita
how does epidermolysis bullosa present
skin blistering in response to minor injury
what are the 3 types of epidermolysis bullosa
simplex
junctional
dystrophic
where does simplex epidermolysis bullosa affect
how does it present (scarring)
epidermis
no scarring involved
where does junctional epidermolysis bullosa affect
how does it present (scarring)
epidermal-dermal junction
some scarring
where does dystrophic epidermolysis bullosa affect
how does it present (scarring)
dermis
heals with v bad scarring, can cause loss/fusion of digits
prognosis
very variable! cant tell at birth
what does dermatitis herpetiformis look like on histology
papillary dermal microabscesses
IgA positive dermal papillae
dermatitis herpetiformis
