OnlineMedEd: Dermatology - "Bullous Disease"

Question 1

Describe the molecular connections important to know for bullous disorders.

Answer 1

• Desmosomes: connections between the epidermis cells

* Hemidesmosomes: connections between the epidermal cells and their basement membrane

Question 2

Loss of desmosomes leads to ______________.

Answer 2

pemphigus vulgaris

“It’s VULGAR –it’s the bad one, so the cell layer is not intact.”

Question 3

Loss of hemidesmosomes leads to _____________.

Answer 3

bullous pemphigoid

Question 4

Rupture of blisters with gentle traction is called ___________ sign.

Answer 4

Nikolsky

Question 5

If you ever see someone with a blistering disease, you need to check for involvement of the ____________.

Answer 5

mucosa

Pemphigus vulgaris has involvement, bullous pemphigoid does not.

Question 6

Why is pemphigus vulgaris an important diagnosis to make?

Answer 6

Blistering of the oral mucosa can lead to airway compromise. Treatment with steroids (first-line) and immunosuppressants like mycophenolate mofetil or rituximab (second-line) can be life-saving.

Question 7

Bullous pemphigoid typically affects patients that are ___________, compared to pemphigus vulgaris.

Answer 7

older

• BP: 60s
• PV: 30s

Question 8

______________ is a cutaneous manifestation of a GI disease.

Answer 8

Dermatitis herpetiformis

Question 9

Dermatitis herpetiformis results from _____________.

Answer 9

IgA deposition in the dermal papillae

Question 10

Dermatitis herpetiformis looks like ________________.

Answer 10

herpes (it is a vesicular disorder)

Question 11

Anti-transglutaminase and anti-_____________ are found in celiac.

Answer 11

endomyosial

Question 12

______________ presents with easy blistering on sun-exposed areas.

Answer 12

Porphyria cutanea tarda

Question 13

How do you diagnose porphyria cutanea tarda?

Answer 13

Sign a wood’s lamp on urine to look for discoloration

Question 14

Porphyria cutanea tarda can be triggered by _______________.

Answer 14

oral contraceptives or HCV

Question 15

What can be used for symptomatic relief in dermatitis herpetiformis?

Answer 15

Dapsone