“What are Key Differences Between Pemphigus & Pemphigoid?”

7.12.24 Quick Review #176 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental Pemphigus: 1. Pathogenesis: characterized by autoantibodies against desmogleins, proteins that form the intercellular junctions (desmosomes) between keratinocytes in the epidermis. This leads to a loss of cell-to-cell adhesion, resulting in intraepidermal blisters. 2. Types: • Pemphigus Vulgaris: The most common type, typically involves mucous membranes and skin. Blisters are flaccid and easily rupture, leaving painful erosions. • Pemphigus Foliaceus: Primarily affects the skin with superficial blisters, rarely involving mucous membranes. 3. Clinical Features: • Blisters and erosions on skin and mucous membranes. • Nikolsky sign positive (skin shears off easily when rubbed). 4. Histopathology: • Acantholysis (loss of intercellular connections) within the epidermis. • Intraepidermal blister formation. 5. Diagnosis: • Direct immunofluorescence showing intercellular deposition of IgG and C3 within the epidermis. • ELISA for desmoglein antibodies. Pemphigoid: 1. Pathogenesis: characterized by autoantibodies against components of the basement membrane zone, such as BP180 and BP230, leading to subepidermal blistering. 2. Types: • Bullous Pemphigoid: The most common type, typically affects elderly individuals and primarily involves the skin. • Mucous Membrane Pemphigoid: Also known as cicatricial pemphigoid, it predominantly affects mucous membranes and can lead to scarring. 3. Clinical Features: • Tense, less easily ruptured blisters on skin or mucous membranes. • Nikolsky sign usually negative. • Pruritus is common in bullous pemphigoid. 4. Histopathology: • Subepidermal blister formation. • Presence of inflammatory infiltrate, often with eosinophils, at the dermal-epidermal junction. 5. Diagnosis: • Direct immunofluorescence showing linear deposition of IgG and C3 at the basement membrane zone. • ELISA for BP180 and BP230 antibodies. References: 1. Bieber, K., Kridin, K., Emtenani, S., Boch, K., Schmidt, E., & Ludwig, R. J. (2021). Milestones in personalized medicine in pemphigus and pemphigoid. Frontiers in Immunology, 11, Article 591971. 2. Bolognia, J. L., Schaffer, J. V., & Cerroni, L. (2018). Dermatology (4th ed.). Elsevier. 3. James, W. D., Elston, D. M., Treat, J. R., & Rosenbach, M. A. (2020). Andrews’ Diseases of the Skin: Clinical Dermatology (13th ed.). Elsevier. 4. ChatGPT. 2024. - #podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency #oralsurgeon #dentist #doctorgallagher