Term
| State the 4 conditions in which Nikolsky's sign is positive |
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Definition
| Staphylococcal scalded skin syndrome Pemphigus vulgaris Epidermolysis Bullosa Simplex Toxic Epidermal Necroloysis |
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Term
| What investigations are most useful in the diagnosis of blistering skin diseases? |
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Definition
Skin biopsy for direct IMF
Blister fluid for indirect IMF
Blister fluid for culture - bacterial, fungal
Blister fluid for PCR serology
Blood for exclusion of porphyria |
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Term
True or false
Orf is a serious condition requiring immediate treatment with antibiotics. |
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Definition
False
It is caused by a para pox virus and is self limiting |
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Term
| True or false. Human Tinea infections commonly cause blistering disease. |
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Definition
| False but zoophilic species may cause blistering. |
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Term
| Fact: Bullous pemphigoid is the commonest immunological cause of blistering skin disease. |
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Definition
It is self limiting and has a low mortality rate. Treatment may include:
T opical steroids
O ral steroids
C yclophosphamide
A zathioprine
TOCA |
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Term
Cicatricial pemphigoid
True or false
This is self limiting |
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Definition
False. This is a scarring mucosal variant of bullous pemphigoid. Strictures and blindness may occur. Treated systemically as with pemphigus v.
Oral steroids
Cyclophosphamide
Azathioprine |
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Term
| Pemphigus vulgaris. True or false. This mainly affects the face scalp trunk and flexures in Jewish and Indian people. |
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Definition
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Term
| Pemphigus follaceous. True false. This is a very aggressive form of pemphigus vulgaris. |
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Definition
| False. It is milder and runs an indolent course. |
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Term
| Linear IgA disease. Older or younger patients are chiefly affected? |
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Definition
| Children and young adults |
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Term
| At what approximate age are most patients with epidermolysis bullosa diagnosed? |
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Definition
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Term
Pemphigus vulgaris. Does this condition exhibit tense or fragile blisters?
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Definition
Fragile, not tense blisters.
Nikolsky’s sign is even producible.
IgG becomes concentrated in the Supra-basal layer cf Bullous Pemphigoid where IgG is in the deeper Basement Membrane zone (Lamina lucida) or dermo-epidermal junction. |
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Term
Is Pemphigus vulgaris usually itchy?
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Definition
| No, and nor is Epidermolysis bullosa, another blistering skin disease. |
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Term
What skin disease gives a “String of pearls” appearance? (Rash consisting of a ring of blisters)
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Definition
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Term
| Name two blistering diseases which are IgA mediated |
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Definition
Linear IgA disease (LAD)
Dermatitis herpetiformis |
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Term
| Which body sites are chiefly affected by dermatitis herpetiformis? |
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Definition
| Elbows, knees and buttocks |
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Term
What photosensitive bullous skin disease has a link with hepatitis C infection and alcohol abuse?
Clue: Lesions are usually found on the dorsum of the hands |
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Definition
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