Vesiculobullous Conditions

Question 1

what is a bulla

Answer 1

blister, more than 1cm in diametre that contains clear, serous or haemorrhagic fluid

Question 2

what is a vesicle

Answer 2

a small blister, less than 1cm n diametre that contains clear, serous or haemorrhagic fluid

Question 3

2 broad classifications for vesiculobullous conditions

Answer 3

1. intra-epithelial
2. sub-epithelial

Question 4

what are vesiculobullous conditions as a result of

Answer 4

production of antibodies against components of the epithelium or basement membrane zone

Question 5

intra–epithelial conditions

Answer 5

• pemphigus vulgaris
• viral infections - herpes simplex, herpes zoster and coxsackie infections

Question 6

sub-epithelial vesiculobullous conditions

Answer 6

• erthema multiforme
• pemphigoid
• dermatitis herpetiformis

Question 7

what can intra-epithelial conditions be further divided into

Answer 7

acantholytic
non-acantholytic

Question 8

pemphigus vulgaris clinical features

Answer 8

flacid bullae/vesicles which rupture easily to leave areas of erosion and ulceration

Question 9

investigations for pemphigus vulgaris

Answer 9

direct immunofluorescence (DIF) and/or indirect immunofluorescence (IDIF) and ELISA (enzyme linked immunosorbent assay)
normally 2 biospies are taken

Question 10

pemphigus vulgaris management

Answer 10

referral to secondary care

Question 11

local and systemic management of pemphigus vulgaris

Answer 11

local:
topical analgesics
topical steroids
systemic:
prednisolone
DMARDs
Rituximab

Question 12

mucous membrane pemphigoid features

Answer 12

turgid (tense) bullae/ vesicles which rupture to leave areas of erosion and ulceration

Question 13

management of mucous membrane pemphigoid

Answer 13

topical analgesic
topical steroids
systemic: doxcycline, dapsone, prednisolone, DMARDs