Vesiculobullous Disease 2 Flashcards
Pemphigoid
- relatively common
- sub epithelial antibody attack
- thick walled blisters (full epidermis)
- usually persist to be seen
- clear/ blood filled blisters
Different forms and presentation of pemphigoid
- Bullous pemphigoid - skin
- Mucous membrane pemphigoid
- all mucous membrane
- eye, genital, oral - Cicatritial pemphigoid
- mucosal with scarring
Histopathology of pemphigoid
- sub epithelial split at epithelial/ CT junction
- Hemi- desmosomes involved at basement membrane
Clinical appearance of Pemphigoid on skin
Immunofluorescence of Pemphigoid
- linear staining along basement membrane
- C3 and IgG detected in this area in standard pemphigoid
- IgA sometimes found
*Linear staining with C3 is called “Linear IgA disease”
*Granular IgA and C3 deposits is seen in Dermatitis Herpetiformis
Pemphigoid- Symblepharon
- scarring of conjunctiva which bind eye surface of eyelid
Where can you normally pemphigoid?
Oral & skin lesions
- both can cause lesion
- bullous usually involves skin
- mucous membrane usually mouth/ eye/ genital
(need to involve specialist)
Scarring
- scarring when healing in Cicatritial pemphigoid
What happen after healing for Cicatritial pemphigoid?
scarring
Management of Pemphigoid
- Steroid
- Immune modulating drug
- Azathioprine
- Mycophenolate
About pemphigus
- commonest is Pemphigus vulgaris
- intraepithelial bullae
Clinical
- uncommon before age 50
- Female > male
- genetic - Ashkenazi Jews
Which sites may cause Pemphigus
- skin
- mucosa - often first site
- both eventually involved
- blisters - burst - spread
Histopathology of Pemphigus
- supra-basal split, only desmosome involved
- tzank cells
- basket- weave pattern
- intraepithelial
Immunofluorescence for Pemphigus
- basket- weave staining around each of epithelial cells
- C3 and IgG in Pemphigus Vulgaris
Clinical photos of pemphigus
More photos Pemphigus
