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Vesiculobullous diseases-1

Epithelium alteration of rete pegs epithelium forms

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Unformatted text preview: ithelium Alteration of rete pegs Epithelium forms the roof of the blisters Auto antibodies are formed against the Auto hemidesmosomes (BPAG-1,230kd;BPAG-2; 180kd. hemidesmosomes Inflammatory Inflammatory cells(lymphocytes,neutrophils,eosinophils)are seen in the later stages in PEMPHGOID PEMPHGOID PEMPHGOID PEMPHGOID CLINICAL FEATURES(MMP) CLINICAL Oral mucosa is the first site- lesions are rarely wide spread wide Subepithelial bullae, ruptured in the later stages. Bleeding in the bullae – bleeding blisters Slow progress, skin involvement absent or rare Involvement of eyes, nose larynx, pharynx and Involvement osephaghus Nikolsky sign is positive PEMPHGOID PEMPHGOID occular involvement PEMPHGOID PEMPHGOID CASCADEOF EVENTS Antibody antigen complex ↓ Complement activation ↓ Neutrophils & Eosinophils recruited Neutrophils ↓ Release of proteases by the recruited cells ↓ Sub epithelial blister formation PEMPHGOID PEMPHGOID PEMPHGOID PEMPHGOID MANAGEMENT Confirm diagnosis Topical corticosteroids Ocular involvement –systemic steroids. ERYTEMA MULTIFORME MULTIFORME ERYTEMA MULTIFORME ERYTEMA Mucocutaneous disease Males adolosents , young adults are Males affected more affected ERYTEMA MULTIFORME ERYTEMA AETIOLOGY /PATHOLOGY Unclear aetiology and pathogenesis Infections like HSV can trigger this disease Drugs like Sulphonamides ,barbiturates Suggested cause is also given as to a type Suggested III hypersensitivity reaction III ERYTEMA MULTIFORME ERYTEMA CLINICAL FEATURES Prodomal signs: Upper respiratory infection Headache and malaise Headache Nausea and arthralgia Nausea C/Fcont…d C/Fcont…d ERYTEMA MULTIFORME ERYTEMA Signs during the disease: Red macules – 1cm or more in diameter with Red cyanotic center cyanotic Lips grossly swollen ,split crusted bleeding Widespread fibrin covered erosions and erythema in the mouth. erythema Mild fever Conjunctivitis may be associated Conjunctivitis Attacks recur at the intervals of several months Attacks Usually self limiting. ERYTEMA MULTIFORME ERYTEMA ERYTEMA MULTIFORME ERYTEMA HISTOPATHOLOGY Necrosis of the kertinocytes Inter & int...
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