Dermatología an der Universidad Peruana Cayetano Heredia

Pemphigus is an autoimmune disorder against desmoglein. It’s present in desmosomes that interconnect the epithelial cells of the epidermis.

Pemphigus Vulgaris: the destruction is [intra-epidermal ], the blister is thin and tears easily [Nikolsky’s Sign]

Biopsy (showing a tombstone). Also can use immunofluorescence, see antibodies on epithelial cells

Systemic steroids. Once controlled, used steroid-sparing (immune modulators as mycophenolate mofetil, rituximab). 

It can be life-threatening, involves mucosa and the age is 30-50 years.

Pemphigoid is another autoimmune disorder, this time against the hemidesmosomes that attach basement membrane cells to the basement membrane (sub-epidermal lesion).

Nikolsky +

a biopsy is used for diagnosis showing intact epithelium that’s detached from the basement membrane. Immunofluorescence shows antibodies at the dermal-epidermal junction.

steroids during acute attacks – topical for limited disease, systemic for severe.

This ISN’T life-threatening and DOESN’T involve the mucosa. It’s most commonly found in ages 70-80.

This isn’t a true blistering disease but is commonly tested against them. It’s another autoimmune disease caused by IgA antibodies against transglutaminase. It’s the cutaneous manifestation of celiac sprue and has the same pathology.

-Antibody-antigen complex gets deposited at the dermal papillae and causes an extension of the epidermis.

- small vesicular eruptions that are pruritic and found on the buttocks/legs or extensor surfaces