Bullous diseases

Question 1

what is this a presentation of?

Answer 1

bullous pemphigoid

autoimmune sub-epidermal blistering disease in elderly

IgG autoantibody mediated

pruritus

rare mucosal involvement

Question 2

why is bullous pemphigold bulla intact?

Answer 2

sub-epidermal blister

Question 3

Tx for bullous pemphigold

Answer 3

topical corticosteroids or intralesional steroids for localized

systemic corticosteroids for extensive

Question 4

what is this a presentation of?

Answer 4

pemphigus vulgaris

chronic, autoimmune blistering disease

>60s

painful sores in mouth

ashkenazi jews and certain HLA types

Question 5

What is Nikolsky’s sign?

Answer 5

slight rubbing of skin will extend bullae or cause erosion

Question 6

Tx for bullous pemphigoid

Answer 6

IVIG

cyclosporine

rituximab

(systemic immunosuppression)

Question 7

what is this a presentation of?

Answer 7

dermatitis herpetiformis

gluten-sensitive enteropathy

small blisters (papulovesicular eruption over extensor surfaces)

excoriation

deposition of IgA immune complexes

Question 8

Tx for dermatitis herpetiformis

Answer 8

gluten free diet

dapsone

Question 9

list the phases of wound healing

Answer 9

hemostasis

inflammatory

proliferative (weeks)

remodelling (months)

chronic wounds stall in the inflammatory phase

Question 10

list the etiology of non-healing wound

Answer 10

vascular (lack of blood flow)

infection/inflammation

pressure

edema