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Blistering skin conditions (Inherited (Epidermolysis bullosa dystrophica…
Blistering
skin conditions
Inherited
Epidermolysis bullosa dystrophica
Mutation collagen 7 in BM
More severe
Junctional epidermolysis bullosa
Mutation type 17 collagen
Very severe - death in infancy/early childhood
Epidermolysis bullosa simplex
Cytoskeletal proteins of basal epidermis
Usually mild
Inherited desmosome disorders
Weakness in desmosome plaque
Fragility and erosions (no blisters)
Aquired
Infections
Bullous impetigo
Staphlococcal scalded skin syndrome
Herpes simplex (oral/genital)
Chickenpox
Dermatitis herpetiformis
Autoimmune
Pemphigus
vulgaris
Pathophysiology
IgG to desmosomes causing
separation of keratinocytes
Clinical presentation
FLACCID superficial blisters, rupture to erosions
Often mucosal involvement
Epidemiology
Younger people (<40y)
Diagnosis
Skin biopsy: IgG crazy paving effect
Management
Steroids (PO prednisolone)
Rituximab, IV Ig
Bullous
pemphigoid
Clinical presentation
TENSE blisters 1-3cm
Inflamed/normal skin
Mucosal involvement rare
Diagnosis
History: tense blisters
Examination: tense blisters
Skin biopsy: IgG and C3 in BM
Pathophysiology
IgG autoantibodies to BM
Epidemiology
Elderly
Management
Steroids (topical clobetasol, PO prednisolone)
Prognosis
Heal w/o scarring
Relapsing/remitting
Trauma
Insect bites
Friction/trauma
