Skin/Vesiculobullous Diseases

Objectives

Pemphigus
- Define acantholysis, the Nikolsky sign and the Asboe Hansen sign
- Discuss the clinical appearance of pemphigus vulgaris and pemphigus foliaceus
- State the characteristic histologic and immunofluorescence findings in pemphigus vulgaris and pemphigus foliaceus
Pemphigoid
- State the characteristic histologic and immunofluorescent findings in pemphigoid
- Discuss the clinical picture and treatment of bullous pemphigoid and cicatricial pemphigoid
Dermatitis herpetiformis
- Discuss the clinical picture and treatment of dermatitis herpetiformis
- List the characteristic histologic and immunofluorescent findings in dermatitis herpetiformis
Staphylococcal Scalded Skin Syndrome
- List the cause and treatment of Staphylococcal scalded skin syndrome
- Describe the differences between Staphylococcal scalded skin syndrome and toxic epidermal necrolysis
List the immunopathology of pemphigus, dermatitis herpetiformis, linear IgA disease, epidermolysis bullosa acquisita and bullous pemphigoid.

Clinical

Pemphigus Vulgaris: Flaccid blisters, denuded skin, mucosal lesions
Pemphigus Foliaceus: Crusts & shallow erosion on scalp, central face, neck, upper chest and back
Dermatitis Herpetiformis: Burning, itchy small papules & vesicles over extensor surfaces, associated gluten-sensitive enteropathy & other autoimmune disorders
Bullous Pemphigoid: Large, tense blisters on flexor surfaces, mucosal lesions
Staphylococcal Scalded Skin Syndrome: Erythema with superficial desquamation

Immunofluorescence