Bullous Disease Quiz: Pemphigus and Gestational Pemphigoid

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Questions and Answers

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

  • IgA
  • IgG (correct)
  • C3
  • IgM

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

  • Colchicine
  • MTX (correct)
  • HCQ
  • Cyclosporine

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

  • Methotrexate
  • Steroid
  • Dapsone
  • Cyclosporine (correct)

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?

<p>24 (A)</p> Signup and view all the answers

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?

<p>Local toxin (D)</p> Signup and view all the answers

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

<p>Type 4 collagen and anchoring fibrils (C)</p> Signup and view all the answers

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

<p>Dapsone (B)</p> Signup and view all the answers

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

<p>Delivery (A)</p> Signup and view all the answers

What is the antigen associated with cicatricial pemphigoid?

<p>Collagen 17 (B)</p> Signup and view all the answers

Which underlying malignancy is associated with cicatricial pemphigoid?

<p>Lung cancer (D)</p> Signup and view all the answers

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

<p>BPAG 1 (C)</p> Signup and view all the answers

What is the treatment using biologic for bullous pemphigoid?

<p>Rituximab (A)</p> Signup and view all the answers

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

<p>Stop drug (B)</p> Signup and view all the answers

Which biologic treatment is safest during pregnancy?

<p>Certolizumab (A)</p> Signup and view all the answers

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

<p>Dapsone (A)</p> Signup and view all the answers

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?

<p>Liver (B)</p> Signup and view all the answers

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

<p>Acute generalized exanthem pustulosis (B)</p> Signup and view all the answers

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?

<p>Dapsone (D)</p> Signup and view all the answers

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

<p>Delivery (D)</p> Signup and view all the answers

What antigen is associated with cicatricial pemphigoid?

<p>BPAG 2 col 17 laminin 5 epiligrin (B)</p> Signup and view all the answers

Which underlying malignancy is associated with cicatricial pemphigoid?

<p>Lung cancer (C)</p> Signup and view all the answers

Which biologic treatment is most appropriate for bullous pemphigoid?

<p>Rituximab (D)</p> Signup and view all the answers

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

<p>Dapsone (D)</p> Signup and view all the answers

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)?

<p>Lung (C)</p> Signup and view all the answers

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

<p>Local toxin (C)</p> Signup and view all the answers

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)?

<p>Phlebotomy (C)</p> Signup and view all the answers

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?

<p>Gastroendoscopy (B)</p> Signup and view all the answers

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?

<p>IgG (A)</p> Signup and view all the answers

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?

<p>24 (B)</p> Signup and view all the answers

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

<p>Lung cancer (D)</p> Signup and view all the answers

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

<p>Type 4 and anchoring fibrils (B)</p> Signup and view all the answers

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?

<p>IgG (D)</p> Signup and view all the answers

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

<p>Local toxin (A)</p> Signup and view all the answers

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?

<p>Renal system (A)</p> Signup and view all the answers

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

<p>BP180 (D)</p> Signup and view all the answers

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?

<p>48 (B)</p> Signup and view all the answers

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?

<p>Local toxin (C)</p> Signup and view all the answers

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

<p>Dapsone (C)</p> Signup and view all the answers

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?

<p>Stomach (D)</p> Signup and view all the answers

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

<p>Lamina Densa (C)</p> Signup and view all the answers

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

<p>Dapsone (A)</p> Signup and view all the answers

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

<p>Hydroxychloroquine (C)</p> Signup and view all the answers

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

<p>Steroid (D)</p> Signup and view all the answers

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?

<p>9 (B)</p> Signup and view all the answers

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

<p>Local toxin (C)</p> Signup and view all the answers

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

<p>Type 4 and anchoring fibrils (A)</p> Signup and view all the answers

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)?

<p>Phlebotomy (B)</p> Signup and view all the answers

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?

<p>Dapsone (A)</p> Signup and view all the answers

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

<p>Increase dose to 2 mg/kg (B)</p> Signup and view all the answers

What is the antigen of cicatricial pemphigoid?

<p>Collagen 17 laminin 5 (A)</p> Signup and view all the answers

Which underlying malignancy is associated with cicatricial pemphigoid?

<p>Pancreatic cancer (A)</p> Signup and view all the answers

What is the most safe biologic during pregnancy treatment?

<p>Ustekinumab (A)</p> Signup and view all the answers

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

<p>Steroid (A)</p> Signup and view all the answers

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

<p>Lung (A)</p> Signup and view all the answers

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

<p>Acute generalized exanthem pustulosis (C)</p> Signup and view all the answers

"Salt split test separates skin at" which layer?

<p>Lamina lucida (B)</p> Signup and view all the answers

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

<p>Hematological malignancy (A)</p> Signup and view all the answers

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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

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