Vesiculobullous Diseases Flashcards
Highly contagious superficial skin infection. Rapid blister, asx, FLACCID
Impetigo.
“Honey crusted lesion”
Bullous impetigo.
Most common causes of impetigo
Staph aureus or Strep pyogenes. Infect skin breaks (i.e. due to atopic dermatitis, herpes infection, trauma).
Tx of impetigo
antibiotics
Toxin mediated exfoliative dermatitis. Exotoxin destroys keratinocyte attachments in straum granulosum only, Fever, orange/red macules, sloughing of upper layers of epidermis. Children/infants/daycares/renal failure.
What is this?
Physical exam sign
Staph Scalded Skin Syndrome
+ Nikolsky sign (rubbed area of skin sloughs off)
Pathogenesis of SSSS
Staph aureus, type 2
Skin and oral mucosa with flaccid intraepidermal bulla. IgG autoantibody against Desmoglein 3
Pemphigus Vulgaris
Physical exam signs of Pemphigus Vulgaris
+ Nikolsky (rubbed area of skin sloughs off)
+ Asboe-Hansen Sign (lateral prssure on bulla will spread bulla to uninvolved skin)
What disease is associated with PV?
Dx and tx of Pemphigus Vulgaris?
Myasthenia gravis and thymoma are associated with PV.
Dx - biopsy
Tx - imuran, prednisone, Consult opthomology
Encephalitis, seizures, HA. Spread by respiratory droplets or genetalia contact. Prodrome: itching/burning. Vescicles/ulcer on erythematous base, recurrent.
What is this?
HSV1 (oral)
HSV2 (Gentalia)
What is herpetic whitlow and herpes gladitorum
Whitlow - herpes n finger
gladitorium - along ears, in wrestlers
“Dew drop on rose petal” or “oval teardrop on erythematous base”.
Face/trunk, aphthous ulcers, spares distal extremities.
Varicella Zoster virus (chickenpox).
Do not give what to to peds with VZ Virus
Tx
Aspirin
Tx - VZIG, antivirals, antihistamines
Autoantibodies of IgG against __ antigens 1 and 2. Chronic, autoimmune, SUBepidermal blistering.
Tense bulla containing eospinohils.
Bullpous pemphigoid.
Immunofluorescence of BP.
tx of bullous pemphigoid
Linear pattern
prednisone, immunosuppressives
Type 4 HSR. Idiopathic photodermatoses relating to sun exposure (UV-A or UV-B). Native American! Spring time! 30 min after sun exposure.
Polymorphous Light Eruption
Rare immune mediated skin disease with gluten sensitive enteropathy. IgA mediated (dermal papilla).
Dermatitis Herpetiformis
A person presents with pruritic, grouped/symmetric/burning skin blisters. Urticarial wheal to vescicle to bulla.
What is this?
What immunologic markers?
Dermatitis Herpetiformis
Increased expression of HLA-B1, B8, DR8, DRQ
Tx of dermatitis herpetiformis.
dapson, gluten free diet
B9, self limiting eruption. Targetoid or iris shaped macules or vesiculopapules on palms or soles. Dull red, sometimes mucosal involvent, symmetric involvement.
What is this?
What associated phenomenon? Associated infection?
Erythema multiforme
Koebner phenomenon
HSV
The major variant of Erythema Multiforme must be hospitalized bc…
affects oropharynx
Extensive full thickness skin attachment. 1-3 week prodrome with fever, skin tenderness/pain, crinkled surface. Associated with HLA-B12, worse in SLE, HLA, meds/infections.
What is this?
What sign is associated with it?
Toxic Epidermal Necrolysis
+Nikolsky
Tx of TEN
IV fluids, burn unit, steroids as last resort.
