Vesiculobullous and Immune Disease 2 Flashcards
what occurs at the tissue level in pemphigoid
separation of the epithelium at basement membrane from connective tissue
what tissue does bullous pemphigoid affect
skin
how are pemphigoid blisters formed
the full thickness of epithelium is released with inflammatory exudate filling the space between epidermis and connective tissue
why may blisters in pemphigoid appear clear or blood filled
fluid can come from connective tissue where there is damage which can cause leakage of RBCs into the fluid
where is it important to take a tissue sample from when investigating pemphigoid
around the lesion (peri-lesional) as if taken from the lesion often no epithelial cells are found
what attaches the epithelial layer to the basement membrane
hemidesmosomes
what does the circulating antibody attack in pemphigoid
hemidesmosomes
what are two major worries about pemphigoid
loss of barrier from infection
weeping of fluid can cause dehydration
how is pemphigoid diagnosed
using direct immunofluorescence
what would be seen in direct immunofluorescence in a patient with pemphigoid
separation between epithelium and connective tissue
linear staining on basement membrane
what is symblepharon
a category of pemphigoid where scarring of conjunctiva binds the eye surface to eyelid which restricts eye movement
what is the category of pemphigoid that causes scarring when healing
cicatritial
how is pemphigoid managed
steroids
immune modulating drugs - azathioprine and mycophenolate
what is pemphigus
immune mediated antibody directed disease where circulating antibody attacks cell-cell adhesion in epithelium
what forms in pemphigus
intra-epithelial bullae as fluid fills space between the cells, cells get pushed further away
