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Itchy skin disease

Blistering skin diseases key points test

Blisters are: #! Accumulations of fluid within the epidermis # Accumulations of fluid above the stratum corneum #! Accumulations of fluid under the epidermis # Accumulations of fluid under the dermis Explanation: Blisters (vesicles and bullae) are fluid-filled swellings and may be intraepidermal (including subcorneal) or subepidermal. The blister is intraepidermal in: #! Some kinds of epidermolysis bullosa # Bullous pemphigoid #! Pemphigus # Dermatitis herpetiformis Explanation: Intraepidermal blisters are characteristic of the most common forms of epidermolysis bullosa (EB simplex) and pemphigus vulgaris (just above basal layer) / foliaceus (more superficial). The blister is subepidermal in: #! Some kinds of epidermolysis bullosa # Bullous pemphigoid #! Pemphigus #! Dermatitis herpetiformis Explanation: Subepidermal blisters are characteristic of epidermolysis bullosa dystrophica (dystrophic EB), dermatitis herpetiformis and bullous pemphigoid. Which condition is most likely in: Mix and match: An adolescent with vesicles and crusts on scalp, elbows and knees: Dermatitis herpetiformis || Dermatitis herpetiformis can present at any age but most often in the second to fourth decade. Extremely itchy grouped vesicles are most frequently located on extensor surfaces. A child with blisters and erosions due to minor trauma: Epidermolysis bullosa || Epidermolysis bullosa is a group of rare inherited bullous disorders characterized by blisters and subsequent erosions provoked by mechanical trauma. Most cases present as infants but mild cases may remain undetected until adulthood. An adult with oral and cutaneous erosions: Pemphigus || Pemphigus describes a group of chronic bullous diseases mediated by circulating autoantibodies directed against keratinocyte cell surfaces. Peak age of onset is from 50 to 60 years. Pemphigus affects the oral mucosa in 50-70% of cases and nearly always also results in painful flaccid blisters on cutaneous surfaces. An elderly patient with erythematosus plaques and firm blisters: Bullous pemphigoid || Bullous pemphigoid is a chronic immunobullous disease with an average age at onset of 65 years. Subepidermal bullae are tense and may arise on any part of the skin especially flexures. Mucosal involvement occurs in about 10% and is usually minor.