Blistering disorders Flashcards
What can blistering skin disorders be divided into
Immunobullous disease - bullous pemphigoid, pemphigus vulgaris
Blistering skin infections - herpes simplex
What does the fragility of blisters depend on
The level of the split within the skin
What type of split causes blisters to rupture easily
Intraepidermal split (split in the epidermis)
What type of split causes blisters to rupture less easily
Sub epidermal split
What is bullous pemphigoid
A blistering skin disorder which usually affects the elderly
What is the cause of bullous pemphigoid
Autoantibodies against antigens between the epidermis and dermis causing a sub epidermal split in the skin
How does bullous pemphigoid present
Tense, fluid filled blisters on an erythematous base
Lesions are often itchy
May be preceded by a non-specific itchy rash
Usually affects the trunk and limbs (mucosal involvement is less common)
How is bullous pemphigoid treated
General measures - wound dressings where appropriate, monitor for signs of infection
Topical therapies - topical steroids
Oral therapies for widespread - oral steroids, combination of oral tetracycline and nicotinamide, immunosuppressive agents (azathioprine, mycophenolate mofetil, methotrexate)
What is pemphigus vulgaris
A blistering skin disorder which usually affects the middle aged
What causes pemphigus vulgaris
Autoantibodies against antigens within the epidermis causing intra-epidermal split in the skin
How does pemphigus vulgaris present
Flaccid, easily ruptured blisters forming erosions and crusts
Lesions are painful
Usually affect mucosal areas - can precede skin involvement
How is pemphigus vulgaris managed
Wound dressings where required, monitor for signs of infection, good oral care if oral mucosa involved
Oral therapies - high dose oral steroids, immunosuppressive agents (methotrexate, azathioprine, cyclophosphamide, mycophenolate mofetil)
