Vesiculobullous Skin Conditions

Lesson on Pemphigus vulgaris and Bullous Pemphigoid, differences and similarities between the two conditions, and diagnoses and treatments for both. Pemphigus vulgaris and Bullous Pemphigoid are autoimmune skin conditions characterized by bullae on the skin, but they differ greatly in their presentation and overall morbidity. In this lesson, you will learn about various clinical signs to distinguish these two conditions, as well as their differing pathophysiologies and treatments.

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JJ

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**MEDICAL DISCLAIMER**: JJ Medicine does not provide medical advice, and the information available on this channel does not offer a diagnosis or advice regarding treatment. Information presented in these lessons is for educational purposes ONLY, and information presented here is not to be used as an alternative to a healthcare professional’s diagnosis and treatment of any person/animal.

Only a physician or other licensed healthcare professional are able to determine the requirement for medical assistance to be given to a patient. Please seek the advice of your physician or other licensed healthcare provider if you have any questions regarding a medical condition.

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*Although I try my best to present accurate information, there may be mistakes in this video. If you do see any mistakes with information in this lesson, please comment and let me know.*

I am always looking for ways to improve my lessons! Please don’t hesitate to leave me feedback and comments – all of your feedback is greatly appreciated! 🙂 And please don’t hesitate to send me any messages if you need any help – I will try my best to be here to help you guys 🙂

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JJ
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Its time to learn about the disorders and diseases of the skin! Hopefully no one ate! When working in skin care it is important that we do not diagnose or attempt to cure a disease. This is a job for the persons doctor or dermatologist. If a client is showing signs of a disease it is important you not do the service and refer them out.
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This is a brief video on infestations of the skin and infectious diseases of the dermis and epidermis.

I created this presentation with Google Slides.
Images were created or taken from Wikimedia Commons
I created this video with the YouTube Video Editor.

ADDITIONAL TAGS:
Cellulitis
Bacterial skin infection → red tender plaque, often on lower leg
Might see streaks of lymphangitis to lymph nodes
Fever, high WBCs, tender lymph nodes, pain
Risk factors: trauma/wounds, systemic infxn, edema, inflammatory state, bug bites
Erysipelas
more superficial, shiny, demarcated cellulitis
Notable dermal lymphatic involvement, usually on legs or face
Impetigo
AKA impetigo contagiosum
Superficial bacterial skin infection
Epi: often in children (2-5 yo), spread among contacts
Abscess
Large mass, red, warm, tender
Can drain pus/fluid
Treat with incision and drainage
If pt has multiple abscesses, immunosuppression, or other cellulitis, treat with oral abx
Furuncle: small perifollicular abscess, (boil)
Folliculitis
Bacterial infection of hair follicles
Looks like small, red, pustules with pus
Usually caused by staph aureus
Staphylococcal scalded skin syndrome
Secretion of staph aureus toxin into blood causes systemic blisters
“Skin peels away in sheets
Necrotizing fasciitis
Bacterial infection of fascia, spreads quickly
Pain unproportional to physical exam findings
Secondary syphilis
Second stage/presentation of sexually transmitted infection syphilis caused by bacterium Treponema pallidum
Secondary syphilis presents with diffuse rash which frequently involves palms of hands, soles of fee
Dermatophytes
Named “tinea _____” for the site of infection
Tinea pedis (athlete’s foot) → foot
Shoes create moisture → infected in public gym, pools, showers
Scaling/redness
Often recurs
Three patterns: interdigital, vesiculobullous, and moccasin types
Can involve nails → onychomycosis (requires oral antifungals (terbinafine) bc poor access with topicals)
Treat with hygiene (change socks, foot powder for dryness) and topical antifungals (imidazoles, allylamines, ciclopirox)
Can lead to lower leg cellulitis (fungal infxn creates portal of entry for bacteria)
Tinea corporis (ringworm) → trunk and limbs
Ring shaped lesion with central clearing → “ringworm”
Causes itching, affects all ages, often asymmetric
Treat similar to tinea pedis, use oral antifungals (terbinafine and fluconazole in severe cases)
Tinea cruris is similar in groin area
Tinea capitis → scalp and hair
Tinea (pityriasis) versicolor
AKA dermatomycosis furfuracea, tinea flava
Eruption of macules/patches on the skin, can be many colors .. tan, salmon, hypopigmented patches or macules
Usually on trunk
Diaper candidiasis
Presents in infant with red erosions in diaper area, with satellite lesions, involving skin folds
Pathogenesis: urease in feces breaks down urea from urine into ammonia → irritates skin → candida from feces enters the skin
Candidal intertrigo
Chicken pox
AKA varicella
Herpes zoster
AKA shingles
Herpes simplex
Kaposi sarcoma
Verruca vulgaris
AKA common wart
Genital warts
Sexually transmitted disease caused by HPV
→ verrucous sessile exophytic papules on external genitalia, perineum, perianal, inguinal fold
Extensive infection in immunocompromised (HIV, organ transplant)
HPV types 6 and 11 typically cause genital warts (recall 16 and 18 cause high grade intraepithelial neoplasia
Prevent with gardasil vaccine, protect against types 6, 11, 16, 18
Treatment: cryotherapy, electrocautery, laser, surgery, imiquimod (TLR7/8 agonist to stimulate immune system
Molluscum contagiosum
Pediculosis
AKA pediculosis capitis, lice
Lice infestation of the human head
Caused by human louse Pediculus humanus var capitis
Causes scalp pruritis (itchiness), might cause posterior cervical lymphadenopathy
Scabies
AKA seven-year itch
Contagious skin infestation by the mite Sarcoptes scabiei
Bed bugs
Human parasite that feeds on human blood found in bedding and sleep areas, active at night
Most common bed bug is Cimex lectularius
Saliva has antiplatelet agents, anticoagulant, vasodilators
Host presents with edematous papules scattered over the body
Treatment: bites resolve in a week or two; topical anti-itch or steroids for symptoms. Clean everything, hire exterminator.
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Herpers simplex
Herpers genital
varicella zoster virus- chicken pox and shingles
Scabies
Yeast candida
folliculitis
impetigo
Ringworm
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http://www.ProBloodborne.com

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