Bullous pemphigoid

Question 1

Case Bullous pemphigoid

Answer 1

85 year old woman complain of worsening eruption of tense bullae on her trunk and
extremities, history of rash started 2 month ago , but blisters are new within past week , urticaria
plaque tense bullae , intense pruritus worse at night , no mucosal involvement

Question 2

Pathology Bullous pemphigoid

Answer 2

1)Chronic autoimmune disorder
2)IgG antibodies against hemidesmosomes and BAAg2 & BpAg 1

Question 3

Lesion Bullous pemphigoid

Answer 3

1)Pruritic tense bullae
2)Sub epidermal bullae
3)Involves flexor surface

Question 4

Differential diagnosis Bullous pemphigoid

Answer 4

1)Pemphigus vulgaris
2)Pemphigus foliaceous

Question 5

Dx Bullous pemphigoid

Answer 5

1)Clinical exam = nikolsky sign + bullae spread sign positive
2)Biopsy = epidermal easinophilia
3)DIF

Question 6

Tx Bullous pemphigoid

Answer 6

1)Tetracycline
2)Steroids
3)Dapsone