Pemphigus vulgaris - Revision history

Rossdonaldson1: /* Background */

2024-12-11T17:27:45Z

Background

← Older revision		Revision as of 17:27, 11 December 2024
Line 1:		Line 1:
	==Background==		==Background==
			{{Skin anatomy background images}}
	*Chronic autoimmune mucocutaneous disease against desmosomes in epidermis (bind keratinocytes)		*Chronic autoimmune mucocutaneous disease against desmosomes in epidermis (bind keratinocytes)
	*Mortality 5-15% sec to complications of long-term steroid therapy.		*Mortality 5-15% sec to complications of long-term steroid therapy.

Rossdonaldson1: /* Clinical Features */

2020-09-10T17:43:14Z

Clinical Features

← Older revision		Revision as of 17:43, 10 September 2020
Line 5:		Line 5:
	==Clinical Features==		==Clinical Features==
	[[File:Pemphgoid vulgaris.jpg\|thumb\|Pemphigus vulgaris of torso.]]		[[File:Pemphgoid vulgaris.jpg\|thumb\|Pemphigus vulgaris of torso.]]
			[[File:PMC5418673 gr1.png\|thumb\|Painful, shallow oral erosions in a patient with pemphigus vulgaris.]]
	[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]		[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]
	*Painful but rarely [[pruritus\|pruritic]]		*Painful but rarely [[pruritus\|pruritic]]

Rossdonaldson1: /* Management */

2020-09-10T17:39:32Z

Management

← Older revision		Revision as of 17:39, 10 September 2020
Line 27:		Line 27:

	==Management==		==Management==
			[[File:PMC3760958 abd-88-0676-g01.png\|thumb\|Pemphigus vulgaris before (A) and after (B) treatment.]]
	*[[IVF]] and electrolyte resuscitation		*[[IVF]] and electrolyte resuscitation
	*Systemic [[corticosteroids]]		*Systemic [[corticosteroids]]

Rossdonaldson1: /* Clinical Features */

2020-09-10T17:36:55Z

Clinical Features

← Older revision		Revision as of 17:36, 10 September 2020
Line 4:		Line 4:

	==Clinical Features==		==Clinical Features==
			[[File:Pemphgoid vulgaris.jpg\|thumb\|Pemphigus vulgaris of torso.]]
	[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]		[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]
	*Painful but rarely [[pruritus\|pruritic]]		*Painful but rarely [[pruritus\|pruritic]]

ClaireLewis: /* Clinical Features */

2019-09-28T01:02:32Z

Clinical Features

← Older revision		Revision as of 01:02, 28 September 2019
Line 5:		Line 5:
	==Clinical Features==		==Clinical Features==
	[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]		[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]
	*Painful but rarely pruritic		*Painful but rarely [[pruritus\|pruritic]]
	*Mucosal involvement common		*Mucosal involvement common
	**Presenting complaint in 50% of cases		**Presenting complaint in 50% of cases
	*Primary lesions		*Primary [[vesiculobullous rashes\|lesions]]
	**Tense and clear vesicles/bullae on head, trunk, mucosa		**Tense and clear vesicles/bullae on head, trunk, mucosa
	**Become flaccid and turbid 2-3 days later		**Become flaccid and turbid 2-3 days later
	**Rupture and leave ~~sensistive~~ denuded area of skin		**Rupture and leave sensitive denuded area of skin
	***Slow to heal and prone to secondary infection		***Slow to heal and prone to secondary infection
	*Nikolsky's sign: Sliding pressure applied to normal skin adjacent to blister causes further ulceration		*Nikolsky's sign: Sliding pressure applied to normal skin adjacent to blister causes further ulceration
	**Intraepidermal ~~acantholyis~~: Keratinocytes separated at the basal layer from one another		**Intraepidermal acantholysis: Keratinocytes separated at the basal layer from one another
	**Gives appearance of lesion expanding into adjacent tissue		**Gives appearance of lesion expanding into adjacent tissue
	**Transudate accumulate between keratinocyte and basement membrane which gives rise to new blisters		**Transudate accumulate between keratinocyte and basement membrane which gives rise to new blisters

ClaireLewis: /* Management */

2019-08-27T21:57:58Z

Management

← Older revision		Revision as of 21:57, 27 August 2019
Line 26:		Line 26:

	==Management==		==Management==
	*IVF and electrolyte resuscitation		*[[IVF]] and electrolyte resuscitation
	*Systemic ~~Corticosteroids~~		*Systemic [[corticosteroids]]
	*IV ~~Antibiotics~~ for signs of secondary infection.		*IV [[antibiotics]] for signs of secondary infection.
	*Consider need for Rheumatology evaluation		*Consider need for Rheumatology evaluation
	**~~Plasmapharesis~~ and [[IVIG]] in severe cases.		**[[Plasmapheresis]] and [[IVIG]] in severe cases.

	==Disposition==		==Disposition==

Rossdonaldson1: Text replacement - "BSA" to "BSA"

2019-02-12T08:32:49Z

Text replacement - "BSA" to "BSA"

← Older revision		Revision as of 08:32, 12 February 2019
Line 37:		Line 37:
	**Difficulty tolerating PO secondary to mucosal blisters		**Difficulty tolerating PO secondary to mucosal blisters
	**Decompensated disease		**Decompensated disease
	**Burn unit for large BSA involvement		**Burn unit for large [[BSA]] involvement

	==See Also==		==See Also==

ClaireLewis: /* Management */

2016-10-10T01:12:21Z

Management

← Older revision		Revision as of 01:12, 10 October 2016
Line 30:		Line 30:
	*IV Antibiotics for signs of secondary infection.		*IV Antibiotics for signs of secondary infection.
	*Consider need for Rheumatology evaluation		*Consider need for Rheumatology evaluation
	**Plasmapharesis and IVIG in severe cases.		**Plasmapharesis and [[IVIG]] in severe cases.

	==Disposition==		==Disposition==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-24T10:59:28Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 10:59, 24 July 2016
Line 21:		Line 21:
	{{Bullous rashes DDX}}		{{Bullous rashes DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Clinical diagnosis. Nikolsky's sign may be helpful to differentiate from other bullous diseases.		*Clinical diagnosis. Nikolsky's sign may be helpful to differentiate from other bullous diseases.
	**Gold standard: punch biopsy		**Gold standard: punch biopsy

Rossdonaldson1: /* Clinical Features */

2016-07-23T22:33:48Z

Clinical Features

← Older revision		Revision as of 22:33, 23 July 2016
Line 4:		Line 4:

	==Clinical Features==		==Clinical Features==
			[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]
	*Painful but rarely pruritic		*Painful but rarely pruritic
	*Mucosal involvement common		*Mucosal involvement common
Line 16:		Line 17:
	**Gives appearance of lesion expanding into adjacent tissue		**Gives appearance of lesion expanding into adjacent tissue
	**Transudate accumulate between keratinocyte and basement membrane which gives rise to new blisters		**Transudate accumulate between keratinocyte and basement membrane which gives rise to new blisters
	~~[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]~~

	==Differential Diagnosis==		==Differential Diagnosis==

← Older revision		Revision as of 17:43, 10 September 2020
Line 5:		Line 5:
	==Clinical Features==		==Clinical Features==
	[[File:Pemphgoid vulgaris.jpg\|thumb\|Pemphigus vulgaris of torso.]]		[[File:Pemphgoid vulgaris.jpg\|thumb\|Pemphigus vulgaris of torso.]]
			[[File:PMC5418673 gr1.png\|thumb\|Painful, shallow oral erosions in a patient with pemphigus vulgaris.]]
	[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]		[[File:pemphigus.JPG\|thumbnail\|Pemphigus vulgaris]]
	*Painful but rarely [[pruritus\|pruritic]]		*Painful but rarely [[pruritus\|pruritic]]