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BLISTERING DISEASES, 3 Types, CHILDREN: mechanical defect, ADULTS :…

- - - - INDIRECT = IgG antibodies in 90%
      - Direct : Positive too
    - - Corticoids topical HIGH potency
    - - Systemic
        
        PREDNISOLONE 1mg/kg/d
        
        LIFE TREATMENT, Just lower doses
        
        Side effects :warning:
        
        Immunosuppressive agent : To reduce steroid
        
        Azathioprine Cyclophosphamide
        
        Mycophenolate Mofetil
  - - - Most superficial
- - - - Chronic
      - Mucous membrane before skin : oral 85%, eye 64%
      - IgG, IgA, C3 basement membrane
      - Scars can cause BLINDNESS --> SYNECHIAE
      - More serious than Blistering
    - - Large Bullous --> SEROUS CONTENT
      - In FLEXURAS
      - Heal WITHOUT Scar
      - Less frequent mouth
  - - - Indirect
        
        NEGATIVE(-) Cicatricial :red_cross:
        
        POSITIVE(+) Blistering
      - Direct
        
        POSITIVE (+)
        
        IgG, C3 basal membrane :check:
  - - - PREDNISONE (DACORTIN) 0.5mg/kg/d
        
        INCREASE dosage by 50% every WEEK until stopped of new lesion
        
        Then , REDUCE dosage 10mg every WEEK until dose maintenance
  - - - SUPPRESS BOTH DRUGS SLOWLY
- - - - Iris + extremities --> TARGET LESION
        
        WHEN TOO SEVERE in EYE : SJS
    - - Skin + Mucous membrane trunk and limbs --> BULLOUS
  - - - 2 mucous surfaces at least
      - Related drugs or infectious
      - ACUTE EYE DISEASE 50%
        
        35% Scars + Corneal Opacification
    - - EXTENSIVE LOSS EPIDERMIS
      - REMOVE CAUSE --> ALL Drugs withdrawn
      - FATAL usually in few days
        
        Shock, Septicemia, Multiorganic failure
  - - - IgM , C3, Perivascular