Concluded Case

PEMPHIGUS VULGARIS

21 years girl Complaining itching burning Blisters on body, lips and mouth, Vaginally area since 2 years. Good respond to treatment. But recurrence more... Diagnosis and treatment pattern,? Diet restrictions...Any suggestions?

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Concluded answer

Visual shows multiple erosions and crusts, and flaccid bullae. Oral, anal and vaginal mucosal involvement. Generalise to body and scalp. These are may be due to development of antibodies against Dsg 3 more favor to PEMPHIGUS VULAGARIS. If it is Dsg 1 ....type could be severe called PEMPHIGUS FOLACEUS. confirmation by Biopsy.. Direct immunofluorence....Ig G antibodies.. ELISA ..can identify the anti Dsg 3 antibodies against antigens Differentials.... TEN...Toxic Epidermal Necrolysis SSS...Staph Scalded Syndrome.. Treatment.... Systemic corticosteroids are mainstay of the Treatment. Before going steroids, should be screened for Osteoporosis, latent TB and fungal infections... Combined pulse therapy is the best option... Prednisolone and cyclophosphamide Mupirocin ointment application on erosion areas... Sebowash shampoo is beneficial for scalp cleansing... Avoid spicy foods. Allow to take plenty of coloured fruits and vegetables Plenty of oral fluids Personal hygienic...

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Psoriasis ??

Visual shows multiple erosions and crusts, and flaccid bullae. Oral, anal and vaginal mucosal involvement. Generalise to body and scalp. These are may be due to development of antibodies against Dsg 3 more favor to PEMPHIGUS VULAGARIS. If it is Dsg 1 ....type could be severe called PEMPHIGUS FOLACEUS. confirmation by Biopsy.. Direct immunofluorence....Ig G antibodies.. ELISA ..can identify the anti Dsg 3 antibodies against antigens Differentials.... TEN...Toxic Epidermal Necrolysis SSS...Staph Scalded Syndrome.. Treatment.... Systemic corticosteroids are mainstay of the Treatment. Before going steroids, should be screened for Osteoporosis, latent TB and fungal infections... Combined pulse therapy is the best option... Prednisolone and cyclophosphamide Mupirocin ointment application on erosion areas... Sebowash shampoo is beneficial for scalp cleansing... Avoid spicy foods. Allow to take plenty of coloured fruits and vegetables Plenty of oral fluids Personal hygienic...

H/o fever? Advise: CBP to check for neutrophilia ANA Skin biopsy ?Bullous sweets syndrome ?pemphigus vulgaris ?Bullous SLE

Thank you Dr. Padmaja Good respond...
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Ecthyma gangrenosa Wet compresses then petroleum jelly or mupricon oint Oral penicillin