Blistering Disorders Flashcards Preview

Year 4k: Dermatology > Blistering Disorders > Flashcards

Flashcards in Blistering Disorders Deck (22)
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1
Q

What causes blistering disorders?

A
  • Fragility of blisters depends on the level of split within the skin – an intra- epidermal split (a split within the epidermis) causes blisters to rupture easily; whereas a sub-epidermal split (a split between the epidermis and dermis) causes blisters to be less fragile.
2
Q

What are examples of blistering disorders?

A

Impetigo

Insect bites

Herpes simplex infection

Herpes zoster infection

Acute contact dermatitis

Pompholyx (vesicular eczema of the hands and feet) and burns.

3
Q

What is a bullous pemphigoid?

A

Blistering skin disorder which usually affects the elderly

4
Q

What is the cause of Bullous Pemphigoid?

A

Autoantibodies against antigens between the epidermis and

dermis causing a sub-epidermal split in the skin

5
Q

What is the presentation of Bullous Pemphigoid?

A
  • Tense, fluid-filled blisters on an erythematous base usually affecting the trunk and limbs (mucosal involvement less common)
  • Lesions are often itchy but may be preceded by a non-specific itchy rash
6
Q

What is the management of Bullous Pemphigoid?

A
  • General measures: wound dressings where required, monitor for signs of infection
  • Topical therapies for localised disease: topical steroids
  • Oral therapies for widespread disease: oral steroids, combination of oral tetracycline and nicotinamide, immunosuppressive agents (e.g. azathioprine, mycophenolate mofetil, methotrexate, and other)
7
Q

What is Pemphigus Vulgaris?

A

A blistering skin disorder which usually affects the middle-aged

8
Q

What is the cause of Pemphigus Vulgaris?

A

Autoantibodies against antigens within the epidermis causing an intra-epidermal split in the skin

9
Q

What is the presentation of Pemphigus Vulgaris?

A
  • Flaccid, easily ruptured blisters forming erosions and crusts
  • Lesions are often painful
  • Usually affects the mucosal areas (can precede skin involvement) - example shown
10
Q

What is the management of Pemphigus Vulgaris?

A
  • General measures: wound dressings where required, monitor for signs of infection, good oral care (if oral mucosa is involved)
  • Oral therapies: high-dose oral steroids, immunosuppressive agents (e.g. methotrexate, azathioprine, cyclophosphamide, mycophenolate mofetil, and other)
11
Q

What is Vitiligo?

A

An acquired depigmenting disorder, where there is complete loss of pigment cells (melanocytes)

12
Q

What is the cause of Vitiligo?

A
  • Thought to be an autoimmune disorder, where the innate immune system causes destruction or loss of melanocytes, leading to loss of pigment formation in the skin
13
Q

What is the presentation of Vitiligo?

A
14
Q

What is the management of Vitiligo?

A
  • Minimise skin injury as a cut, graze, or sunburn can potentially trigger a new patch of vitiligo
  • Topical treatments: topical steroids and calcineurin inhibitors (such as topical tacrolimus and pimecrolimus)
  • Phototherapy: UVB therapy, excimer laser
  • Oral immunosuppressants: methotrexate, ciclosporin and mycophenolate mofetil
15
Q

What is Melasma?

A

An acquired chronic skin disorder, where there is increased pigmentation in the skin

16
Q

What is the cause of Melasma?

A
17
Q

What is the presentation of Melasma?

A
  • Brown macules (freckle-like spots) or larger patches with an irregular border. Has a symmetrical distribution
  • Common sites are forehead, cutaneous upper lips and cheeks, rarely can occur on neck, shoulders and upper arms
18
Q

What is the management of Melasma?

A
  • Lifelong sun protection
  • Discontinuation of hormonal contraceptive pills
  • Cosmetic camouflage
  • Topical treatments that aim at inhibiting the formation of new melanin such as hydroquinone, azelaic acid, kojic acid (a chelating agent) and vitamin C
  • Laser treatments need to be used with caution as the heat generated by lasers can potentially cause post-inflammatory hyperpigmentation.
19
Q

What is a Keloid Scar?

A

An overgrowth of scar tissue, which tends to be larger than the original wound itself

20
Q

What is presentation of Keloid Scars?

A
  • Firm, smooth, hard nodule which can be itchy or painful
  • Common sites are chest and shoulders
21
Q

What is the cause of Keloid Scars?

A
  • Thought to be due to overproduction of collagen during wound healing after minor injuries, skin surgery, insect bites and acne spots in genetically predisposed individuals
  • More commonly seen in darker skin types
22
Q

What is the management of Keloid Scars?

A
  • Avoidance of further trauma to the skin such as scratching
  • Topical treatments such as topical steroids and silicone gel can potentially flatten the scar, and improve the symptoms
  • Intralesional steroid injection if topical treatments are not effective
  • Surgery such as excision needs to be carried out only as the last resort and with caution as the new wound may cause a larger keloid scar