17 - Vesiculobullous and immune disease 2 Flashcards
1
Q
What is pemphigoid?
A
- sub epithelial antibody attack
- the epithelium and connective tissue split
- hemidesmosomes are attacked at the basement membrane
2
Q
How does pemphigoid present?
A
- thick walled blisters (full epidermis)
- blister persists
- can be blood or clear fluid filled
3
Q
What is bullous pemphigoid?
A
Skin only presentation
4
Q
What is mucous membrane pemphigoid?
A
All mucous membranes (eyes, mouth, genitals) presentation
5
Q
What is cicatritial pemphigoid?
A
Mucosal presentation with scarring
6
Q
What are complications associated with pemphigoid?
A
- loss of skin barrier leads to infection
- weeping of fluid leads to dehydration
- complications of treatment
7
Q
What are complications associated with pemphigus?
A
- loss of skin barrier leads to infection
- weeping of fluid leads to dehydration
- complications of treatment
8
Q
How does pemphigoid present with immunofluorescence?
A
- linear along the basement membrane
- C3 and IgG are common antigens
9
Q
What is symblepharon?
A
Scarring of conjunctiva to sclera
10
Q
How do you manage pemphigoid?
A
- steroids
- immune modulating drugs (azathioprine or mycophenolate)
11
Q
What is pemphigus?
A
- intraepithelial bullae form due to desmosomes between cells being targeted
- cells drift way from each other and epithelium thins
12
Q
How does pemphigus present?
A
- common sites include mucosa (first) and skin
- blisters burst quickly so often present with ulceration
- commonly seen in over 50s, more common in females
13
Q
How does pemphigus present with immunofluorescence?
A
- basket weave pattern
- cells floating between the fluorescence
- C3 and IgG are common
14
Q
What is the most common form of pemphigus?
A
- pemphigus vulgaris
- usually presents in the mouth before skin
15
Q
What is the management of pemphigus?
A
- high dose steroids
- immunosuppressants
- biologics
