Autoimmune Blistering Disease

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Conditions in which autoantibodies target components of the skin and mucous membranes, leading  to  blister  and  bullae  formation.  These  include  pemphigus  vulgaris,  foliaceous,  vegetans,  Bullous  pemphigoid, Dermatitis herpetiformis, Linear IgA. 

Clinical presentation 

  • Tense or flaccid Vesicles and bullae on the skin and mucus membranes
  • Vegetative plaques in axillae or groin

Linear IgA

Investigations 

  • Biopsy
  • Immunofluorescence studies
  • FBP, LFT, RFT

Pharmacological Treatment 

C: betamethasone cream/ointment (topical) 12hourly till improves 

OR  

D: clobetasol propionate cream/ointment (topical) 0.05% 12hourly till improves 

AND  

A: prednisolone (PO) 0.5-1mg/kg 24hourly for 2months then taper slowly to lowest effective dose 

AND in extensive involvement 

S: methotrexate (PO) 7.5 – 20mg weekly for not less than 4months 

Treatment of Dermatitis Herpetiformis /pemphigus foliaceous 

S: dapsone (PO)100mg 24hourly for not less than 2months