Vesicuar Skin lesions

Question 1

Where are the different locations of Blisters?

Answer 1

Subcorneal
Intraepidermal
Subepidermal

Question 2

What are the different content types of Blisters?

Answer 2

Cell Poor

W/ inflammation

Question 3

What is the procedure of biopsy for vesicular skin lesions?

Answer 3

Punch biopsy => Formalyn

Deeper biopsy for Ab Immunofluorescence

Question 4

What are the traits of Bullous Pemphigoid?

Answer 4

MOST COMMON bullous Auto Immune Dis
ONLY elderly
Evolves over wks -mon
NOT in mucosa
TENSE Bullae/erytematous skin
SUBEPIDERMAL BLISTER w/ EOSINOPHILS

Question 5

What is Erythrodermic BP?

Answer 5

100% body erythema

Question 6

What is the Tx of Bullous Pmphigoid?

Answer 6

Systemic Steroids/ immsupression
Permanent remission?
Can follow Serum Ab to BP180 and BP230

Question 7

What is Cicatricial Pemphigoid?

Answer 7

BP of mucosal surfaces
Chronic 
Scarring 
Tx immunosupressants 
Similar Histo to BP

Question 8

What is Pemphigoid Gestationis?

Answer 8

Vesicuar eruption on abdomen
Can effect the baby
Can recur in sus pregnancies
White Females

Question 9

What are the Traits of PUPP?

Answer 9

Pruritic papules and plaques of preggo
Umbilical Sparing
In Striae
Dermatitis pathology
Negative DIF

Question 10

What are the Traits of Pregnancy Prurigo?

Answer 10

No blisters 
More coommon
Atopic Eruption of Preggo
Dermatitis Path
Neg DIF

Question 11

What are the traits of Dermatitis Herpetiformis?

Answer 11

Extensor Inv: Elbows/knees
CELIAC DISEASE Tx: Dapsone
Pap, Ves, Bull on erematous or uticarial base

Question 12

What is the PAthogenesis of Dermatitis Herpetiformis?

Answer 12

Ab to Tissue Transglutaminase

Granular IgA deposition in Dermal Papillae

Question 13

What are the traits of Linear IgA Bullous Dermatosis?

Answer 13

Widespread vesicles and bullae
Clusters of jewels
Vancomycin induced LABD

Question 14

What are the Traits of Porphyria Cutanea Tarda

Answer 14

Most Common

Sporadic associated with: Hemochromatisis, Hep C, Ethanol and Estrogens

Question 15

What are the presenting features of PCT?

Answer 15

Blisters on light exposed skin

Tense Bullae on normal background

Question 16

What is the Histo/DIF of PCT?

Answer 16

Cell poor Subepidermal blister

Superficial BV w/ circumferential IgG Deposition

Question 17

What is the Tx of PCT?

Answer 17

Avoid Ethanol and Estrogen
Phlebotomy (Iron)
LD Chloroquine

Question 18

What are the traits of Pemphigus Vulgaris?

Answer 18

AutoAb to IC layers of the Epidermis => Blistering from minor trauma
Chronic
Fatal if not Tx

Question 19

What is the Pathology of PV?

Answer 19

Auto Ab to Desmolegin 1/3

Question 20

What are the presenting features of PV?

Answer 20

Painful but not itchy
Oral mucosa
FLACCID VESICLES on NORMAL SKIN
Erode and Crust

Question 21

What is the Niklsky sign?

Answer 21

Dislodging of epidermis by lateral finger pressure near lesion => erosion

Question 22

What is the DIF apprearance of PV?

Answer 22

Cell surface IgG or C3

CHICKEN WIRE

Question 23

What is the Pathogenesis of Impetigo?

Answer 23

bacterial toxin that cleaves desmolegin 1 molecule (cell-cell adhesion w/in uppermost epidermal layers)

Question 24

What is the Histo of Impetigo?

Answer 24

Superficial blister w/ focal acantholysis

Question 25

What are the traits of Hailey-Hailey Disease?

Answer 25

Benign Fam Pemphigus
Vesicles and bullae => crusting erosions 
Flexural and Intertriginous areas
Tx: Tetracycline
Ca Pump dysfunction

Question 26

What are the Traits of Darier’s Disease?

Answer 26

AD
Ca Pump dysfunction
Multiple discrete scaling papules in seborrheic distribution

Question 27

What are the Traits of Grover’s Disease?

Answer 27

W/ Heavy sweating or heat
Reddish small papules w/ vesicles and erosions
Tx: Topical Steroids or phototherapy