Vesiculobullous Disease 2 Flashcards
Name examples of VBD (5)
Pemphigus
Pemphigoid
Erythema multiforme
Angina bullosa haemorrhagica
Bullous lichen planus
Features of Pemphigoid
Sub epithelial antibody attack
Thick walled blisters (full epidermis)
Usually persist
Clear or blood filled
Different forms of Pemphigoid
Bullous - skin
Mucous - eyes, genitals, oral
Cicatrial - mucosal with scarring
Pemphigus Vs Pemphigoid
Pemphigus
- shallow ulcers break quick
- Intraepithelial bullae
- Rarely intact surface easily lost
- Fatal
Pemphigoid
- Thick walled blisters persist
- Sub epithelial bullae
Histopathology of Pemphigoid
Sub-epithelial split
Hemidesmosomes involved at BM
Biopsy for Pemphigoid/Pemphigus
Perilesional
Consequence of a blister rupture
Exposed connective tisuse
Inflammatory exudate of fluid
Loss of epithelial barrier allowing infection
Dehydration
Diagnostic test for Pemphigoid
Direct immunofluorescence
Linear staining along BM
What antibodies are found in standard pemphigoid/ pemphigus vulgars
C3 +IgG
Clinical features of pemphigus
Intraepithelial bullae
Uncommon before 50
M>F
Most common type of pemphigus
Pemphigus vulgaris
Define pemphigoid symblepharon
Scarring of conjunctiva
Restricts eye movement and causes diplopia
Regular optician chec k ups if suspected oral mucous membrane pemphigoid
Genetic link to pemphigus
Ashkenazi jews
Sites of pemphigus
Skin - up to 3yrs after
Mucosa - oral first before skin
What type = rare to see intact bullae
Pemphigus
