Bullous Disease Quiz: Pemphigus and Gestational Pemphigoid

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57 Questions

What type of immunoglobulin is typically associated with H. gestationis (gestational pemphigoid)?

IgG

In the treatment of pemphigus erythematosus with positive ANA and C3&C4, what would be the most appropriate option?

MTX

For a patient with Pemphigus vulgaris presenting with clefts and protruding villi along with high creatinine levels, what treatment would be most suitable?

Cyclosporine

In a patient diagnosed with Pemphigus vulgaris, who tests positive for desmoglien 3 & 1 antibodies and has a CD20 count of zero, what would be the ideal time for contraception in weeks?

24

If a newly born baby is found with umbilical cord stump still present and bullae around it, what type of toxin is likely responsible for this condition?

Local toxin

What type of defect in collagen is characterized by a defect in type 4 collagen and anchoring fibrils?

Type 4 collagen and anchoring fibrils

Which treatment is most appropriate for histopathology of blistering with IgA and neutrophil, and the presence of DM, HTN, and AF?

Dapsone

In a case where a pregnant female with bullous pemphigoid takes 1 mg/kg of prednisolone with no improvement, what is the next step?

Delivery

What is the antigen associated with cicatricial pemphigoid?

Collagen 17

Which underlying malignancy is associated with cicatricial pemphigoid?

Lung cancer

In para neoplastic pemphigus, which type of antigen is common?

BPAG 1

What is the treatment using biologic for bullous pemphigoid?

Rituximab

In a patient with bullous pemphigoid showing elevated urea and creatinine, what should be the next step?

Stop drug

Which biologic treatment is safest during pregnancy?

Certolizumab

In a scenario of recurrent abdominal pain since childhood with a picture showing EBA with Chron’s disease, what would be the appropriate treatment?

Dapsone

In EBA (Epidermolysis Bullosa Acquisita), which organ is likely to be affected in a male patient presenting with tensile bulla on the arm and no mucosal lesion?

Liver

A patient developed bullae on the arm after 3 days from starting sulfasalazine with a negative DIF. What is the likely diagnosis?

Acute generalized exanthem pustulosis

Which treatment is most appropriate for a patient with histopathology of blistering with IgA and neutrophil and the presence of diabetes mellitus, hypertension, and atrial fibrillation?

Dapsone

In a pregnant female with bullous pemphigoid who takes 1 mg/kg of prednisolone with no improvement, what is the next step?

Delivery

What antigen is associated with cicatricial pemphigoid?

BPAG 2 col 17 laminin 5 epiligrin

Which underlying malignancy is associated with cicatricial pemphigoid?

Lung cancer

Which biologic treatment is most appropriate for bullous pemphigoid?

Rituximab

In a scenario of recurrent abdominal pain since childhood with a picture showing EBA with Crohn’s disease, what would be the appropriate treatment?

Dapsone

In a male patient presenting with tensile bulla on the arm and no mucosal lesion (EBA), which organ is likely to be affected (associated cancer)?

Lung

What type of toxin is likely responsible for the presence of bullae around the umbilical cord stump in a newly born baby?

Local toxin

In a patient with vesicles and blisters on the hands for 8 years, along with lower limb involvement and hypertrichosis, what is the most suitable treatment for PCT (Porphyria Cutanea Tarda)?

Phlebotomy

What is the next appropriate step for a 60-year-old patient presenting with tense bullae without mucous membrane involvement and IgG deposition in the floor?

Gastroendoscopy

In a pregnant female case with bullae on the trunk, flanks, umbilical, and abdomen, what type of immunoglobulin (Ig) is typically associated with H. gestationis?

IgG

What is the ideal time for contraception in weeks for a patient who tests positive for desmoglien 3 & 1 antibodies and has a CD20 count of zero in Pemphigus vulgaris?

24

In a case of Bullous Pemphigoid, which underlying malignancy is commonly associated?

Lung cancer

What type of defect in collagen is characterized by a defect in type 4 collagen and anchoring fibrils?

Type 4 and anchoring fibrils

In a pregnant female case with bullae on the trunk, flanks, umbilical, and abdomen, what type of immunoglobulin (Ig) is typically associated with H. gestationis?

IgG

What type of toxin is likely responsible for the presence of bullae around the umbilical cord stump in a newly born baby?

Local toxin

In EBA (Epidermolysis Bullosa Acquisita), which organ is likely to be affected in a male patient presenting with tensile bulla on the arm and no mucosal lesion?

Renal system

In para neoplastic pemphigus, which type of antigen is common?

BP180

In a patient diagnosed with Pemphigus vulgaris, who tests positive for desmoglein 3 & 1 antibodies and has a CD20 count of zero, what would be the ideal time for contraception in weeks?

48

If a newly born baby is found with umbilical cord stump still present and bullae around it, what type of toxin is likely responsible for this condition?

Local toxin

What is the most appropriate treatment for a patient with granular deposition of IgA in dermal papillae along the basement membrane (Dermatitis Herpetiformis)?

Dapsone

In Epidermolysis Bullosa Acquisita (EBA), which organ is likely to be affected in a male patient presenting with tensile bullae on the arm and no mucosal lesion?

Stomach

What type of defect in collagen is characterized by a defect in type 4 collagen and anchoring fibrils?

Lamina Densa

What is the appropriate treatment for a patient with recurrent abdominal pain since childhood and a picture showing EBA with Crohn’s disease?

Dapsone

What is the most appropriate treatment for a patient with Pemphigus erythematosus positive ANA, C3&C4?

Hydroxychloroquine

In a patient diagnosed with Pemphigus vulgaris with clefts and protruding villi along with high creatinine levels, what treatment would be most suitable?

Steroid

What is the ideal time for contraception in weeks for a patient who tests positive for desmoglien 3 & 1 antibodies and has a CD20 count of zero in Pemphigus vulgaris?

9

In a picture of a newly born with umbilical cord stump still present and bullae around it, what type of toxin is likely responsible?

Local toxin

What type of defect in collagen is characterized by a defect in type 4 collagen and anchoring fibrils?

Type 4 and anchoring fibrils

In a patient with vesicles and blisters on the hands for 8 years, along with lower limb involvement and hypertrichosis, what is the most suitable treatment for Porphyria Cutanea Tarda (PCT)?

Phlebotomy

What is the most appropriate treatment for a patient with histopathology of blistering with IgA and neutrophil, and the presence of diabetes mellitus, hypertension, and atrial fibrillation?

Dapsone

In a pregnant female with bullous pemphigoid who takes 1 mg/kg of prednisolone with no improvement, what is the next step?

Increase dose to 2 mg/kg

What is the antigen of cicatricial pemphigoid?

Collagen 17 laminin 5

Which underlying malignancy is associated with cicatricial pemphigoid?

Pancreatic cancer

What is the most safe biologic during pregnancy treatment?

Ustekinumab

In a scenario of recurrent abdominal pain since childhood & picture of face & ears (EBA with Crohn’s disease), what would be the appropriate treatment?

Steroid

A male patient with tensile bulla on the arm and no mucosal lesions (EBA) since many years, which organ will be affected (associated cancer)?

Lung

A patient developed bullae on the arm after 3 days from starting sulfasalazine DIF –VE. What is the likely diagnosis?

Acute generalized exanthem pustulosis

"Salt split test separates skin at" which layer?

Lamina lucida

"Case of epidermolysis bullosa acquista associated with" what condition?

Hematological malignancy

Study Notes

Pemphigus and Pemphigoid

  • H. gestationis is typically associated with IgG immunoglobulin
  • In Pemphigus erythematosus with positive ANA and C3&C4, the most appropriate treatment is Rituximab
  • In Pemphigus vulgaris with clefts, protruding villi, and high creatinine levels, the most suitable treatment is plasmapheresis and immunosuppressive therapy
  • In Pemphigus vulgaris with positive desmoglein 3 & 1 antibodies and CD20 count of zero, the ideal time for contraception is 6-12 months

Bullous Pemphigoid

  • The treatment using biologic for bullous pemphigoid is Omalizumab
  • In bullous pemphigoid with elevated urea and creatinine, the next step is to reduce the dose of corticosteroids and add mycophenolate mofetil
  • In a pregnant female with bullous pemphigoid who takes 1 mg/kg of prednisolone with no improvement, the next step is to add azathioprine

Epidermolysis Bullosa Acquisita (EBA)

  • In EBA, the affected organ is the kidneys
  • The antigen associated with EBA is type 7 collagen
  • The treatment for EBA with Crohn's disease is prednisolone, azathioprine, and infiximab

Cicatricial Pemphigoid

  • The antigen associated with cicatricial pemphigoid is BP230 and BP180
  • The underlying malignancy associated with cicatricial pemphigoid is lymphoma
  • The treatment for cicatricial pemphigoid is dapsone and topical corticosteroids

Dermatitis Herpetiformis

  • The treatment for dermatitis herpetiformis is dapsone and gluten-free diet

Porphyria Cutanea Tarda (PCT)

  • The treatment for PCT is phlebotomy and chloroquine

Other Conditions

  • The toxin responsible for bullae around the umbilical cord stump in a newly born baby is staphylococcal toxin
  • The defect in collagen characterized by a defect in type 4 collagen and anchoring fibrils is Epidermolysis Bullosa
  • The biologic treatment safest during pregnancy is Omalizumab

Test your knowledge on bullous diseases such as Pemphigus and Gestational Pemphigoid with these case-based questions. Assess your understanding of treatment options, diagnostic indicators, and management strategies.

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