Vesicubullous disease

Question 1

what are the 4 main types of vesicubullous disease

Answer 1

pemphigus vulgaris
bullous pemphigoid
dermatitis herpetiformis (DH)
epidermolysis bullosa (EB)

Question 2

is pemphigus vulgaris a autoimmune disease

Answer 2

yes

Question 3

is pemphigus vulgaris superficial or deep in comparison to bullous pemphigoid?

which layer does it affect

Answer 3

Superficial = pemphigus vulgariS
Deep = bullous pemphigoiD

pemphigus vulgaris affects the epidermis

Question 4

is pemphigus vulgaris serious

Answer 4

yes it can be fatal

Question 5

which vesicubullous disease is most common

Answer 5

pemphigus vulgaris

Question 6

how does pemphigus vulgaris present (3+locations)

Answer 6

painful blisters
burst easily
leaves ulcerated lesions

location - mouth mucosa (plus scalp, axilla, groin, trunk)

Question 7

what is nikolsky sign

Answer 7

when the top layer of skin slips away form lower layers of skin when rubbed slightly

Question 8

is nikolsky sign positive or negative in pemphigus vulgaris

Answer 8

positive

Question 9

when is nikolsky sign negative

Answer 9

in bullous pemphigoid

Question 10

what is acantholysis

Answer 10

breakdown of intercellular adhesion sites = skin falls apart

Question 11

does acantholysis happen in pemphigus vulgaris

Answer 11

yes

Question 12

what is the treatment of pemphigus vulgaris

Answer 12

steroids
topical emollients
topical steroids

Question 13

prognosis of pemphigus vulgaris

Answer 13

fatal if untreated

Question 14

which age group does bullous pemphigoid present in

Answer 14

elderly

Question 15

is bullous pemphigoid superficial or deep in comparison to pemphigus vulgaris?

which layer does it affect

Answer 15

Deep = bullous pemphigoiD
Superficial = pemphigus vulgariS

at the De junction

Question 16

presentation of bullous pemphigoid

Answer 16

itchy but cant burst (too deep)

blistering (occurs after itch)

Question 17

does acantholysis occur in bullous pemphigoid

Answer 17

no, just in pemphigus vulgaris

Question 18

what is the pathophysiology of bullous pemphigoid

Answer 18

IgG react with antigens in basal cells = damage occurs

Question 19

is nikolsky sign negative or positive in bullous pemphigoid

Answer 19

negative - the top layer of skin does NOT slip away when slightly rubbed

Question 20

treatment of bullous pemphigoid (similar to pemphigus but with something additional)

Answer 20

steroids
tetracycline ANTIBIOTICS (different from pemphigus)
topical emollients
topical steroids

Question 21

is dermatitis herppetifrormis common or rare

Answer 21

rare

Question 22

which GI condition is dermatitis herpetiformis strongly associated with

Answer 22

coeliac disease

Question 23

which antibody is involved in dermatitis herpetiformis

Answer 23

IgA

Question 24

where does the pathophysiology of dermatitis herpetiformis take place

Answer 24

DE junction

Question 25

what is the presentation of dermatitis herpetiformis (2 + location)

Answer 25

v itchy lesions on extensor surfaces GI symptoms - fatigue, bloating, change in bowel habit location - extensor surfaces eg elbows, knees, buttocks symmetrically

Question 26

aetiology of epidermolysis bullosa (EB) in children

Answer 26

genetic

Question 27

aetiology of epidermolysis bullosa (EB) in adults what is this also known as

Answer 27

autoimmune EB aquisita

Question 28

how does epidermolysis bullosa present

Answer 28

skin blistering in response to minor injury

Question 29

what are the 3 types of epidermolysis bullosa

Answer 29

simplex junctional dystrophic

Question 30

where does simplex epidermolysis bullosa affect how does it present (scarring)

Answer 30

epidermis no scarring involved

Question 31

where does junctional epidermolysis bullosa affect how does it present (scarring)

Answer 31

epidermal-dermal junction some scarring

Question 32

where does dystrophic epidermolysis bullosa affect how does it present (scarring)

Answer 32

dermis heals with v bad scarring, can cause loss/fusion of digits

Question 33

prognosis

Answer 33

very variable! cant tell at birth

Question 34

what does dermatitis herpetiformis look like on histology

Answer 34

papillary dermal microabscesses

Question 35

IgA positive dermal papillae

Answer 35

dermatitis herpetiformis