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Oral Med > Vesiculobullous Disease > Flashcards

Vesiculobullous Disease Flashcards

1
Q

List examples of VBD’s (5)

A

Erythema Multiforme
Pemphigoid
Pemphigus
Angina bullosa haemorrhagica
Bullous Lichen Planus

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2
Q

List examples of cell mediated immune disease

A

RAU
LP
OFG

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3
Q

List examples of antibody mediated disease

A

Pemphigus
Pemphigoid

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4
Q

Describe how a vesicle forms (5)

A

Autoantibody attack on desmosomes
Loss of cell to cell adhesion
Forms a split in skin
Fills with inflammatory exudate
Forms vesicle (1-2mm)

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5
Q

Function of desmosomes

A

Attach epithelial cells to BM + desmoglein

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6
Q

Test for VBD

A

DIF

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7
Q

How does Direct Immunofluorescence work?

A

For antibody mediated tissue disease (Pemphigus/Pemphigoid)
Antibody bounded to tissue causing disease
Good for diagnosis

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8
Q

How does Indirect Immunofluorescence work?

A

Circulating antibody not yet bound to tissue
Good for monitoring disease activity

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9
Q

Features of erythema multiforme

A

Acute onset
Painful, unable to eat (dehydration)

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10
Q

What can Erythema Multiforme lead to?

A

Steven Johnson Syndrome

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11
Q

Aetiology of Erythema Multiforme

A

HSV
Drugs

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12
Q

Clinical presentation of Erythema Multiforme

A

Central wheel
Coalescent areas of ulceration
Lip crusting
Perilesional area of pale + erythematous tissue

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13
Q

Tx for Erythema Multiforme oral lesions

A

Systemic steroids - Prednisolone
Systemic aciclovir
Fluid intake + analgesia

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14
Q

Tx for Erythema Multiforme recurrent lesions

A

Consider prophylactic Aciclovir
Allergy test

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15
Q

Define angina bullosa haemorrhagica

A

Common oral blood blisters

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16
Q

Presentation of angina bullosa haemorrhagica

A

Rapid onset
Last 1hr then burst
Painless, usually initiated by trauma from eating
Heal with no scars in a few days

17
Q

What is more serious Pemphigoid or Pemphigus?

18
Q

Compare histology of Pemphigoid vs Pemphigus (6)

A

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

PEMPHIGUS
- Supraepithelial split
- Tzank cells
- Basket weave staining

19
Q

Compare clinical features of Pemphigoid vs Pemphigus

A

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

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

20
Q

What do antibodies attack for Pemphigus?

A

Desmosomes

21
Q

What do antibodies attack for Pemphigoid?

A

Hemidesmosomes

22
Q

Tx for Pemphigus/Pemphigoid

A

Refer
Systemic Steroid - Prednisolone
Systemic Immunemodulator - Azathioprine
CHX for plaque control

Oral Med (19 decks)

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