- Pemphigus vulgaris
- Bullous pemphigoid
- Dermatitis herpetiformis
- Pemphigoid gestationis
- Epidermolysis bullosa acquisita
- Bullous lupus erythematosus
Pemphigus vulgaris
IgG antibodies against intercellular attachment sites (desmosomes) between Keratinocytes.
Type II hypersensitivity reaction
Vesicles and bullae develop on skin and oral mucosa.
Intraepithelial vesicles are located above the basal layer (suprabasal)
(1) Basal cells resemble a row of tombstones.
(2) Acantholysis of keratinocytcs in the vesicle fluid
Clinical features
Age: 40-60 years
Usually the site of the blisters are the torso & head and there is always an involvement of the mucus membrane.
The blisters are flaccid and fragile & may have many erosions.
Treatment
Corticosteroids and other immunosuppressive agents (e,g., methotrexate, azathioprine
Pemphigus vulgaris: mucus membrane
Pemphigus vulgaris: Torso
Pemphigus vulgaris
Dermatitis herpetiformis
- IgA-anti-lgA complexes deposit at the tips of the dermal papillae.
- Produces subepidermal vesicles with neutrophils.
- Strongly correlated with celiac disease
- Increase in antireticulin and endomysial antibodies.
Clinical features
Age: young patients associated with coeliac disease.
Sites: Elbow, lower backs, buttocks.
Blisters are often excoriated and not present.
Treatment
(1) Gluten-free diet
(2) Dapsone or sulfapyridine
(3)Nikolsky sign positive
Bullous pemphigoid
IgG antibodies against the basement membrane.
Type II hypersensitivity reaction.
Vesicles are subepidermal
(1) Develop on the skin and oral mucosa.
(2) No acantholytic cells in vesicle lluid
Disease usually subsides after months or years.
Clinical features
Age: 60 and above
Site: Trunk (especially flexures) and limbs with occassional involvement of the mucous membrene.
The blisters are tense.
Treatment
Disease usually subsides after months or years.
May requires systemic corticosteroid in resistant cases.
I’m going to read this. I’ll be sure to come back. thanks for sharing. and also This article gives the light in which we can observe the reality. this is very nice one and gives indepth information. thanks for this nice article... Dr.jill ราคา
ReplyDeleteWe work in front of computers, commute home, and rarely walk. We relax in front of the TV or spend hours on the internet chatting with friends or playing. Lepto Connect reviews
ReplyDeleteCure herbals Permanent Hair Removal Cream is one of the effective herbal formulas that can be use on all type of skin like sensitive and normal.
ReplyDelete