Reactive Skin Diseases and Drug Eruptions MCQs

Epidermolysis Bullosa Acquisita (EBA) Epidermolysis bullosa - congenital, present from birth EBA is not inherited and usually presents in adult life EBA is a rare disease in which tense blisters appear at sites of trauma EBA blisters tend to be localized to areas that are easily injured such as the hands, feet, knees, elbows, and buttocks Sometimes there is mucosal involvement with blisters forming in mouth, nose and eyes EBA may mimic Bullous pemphigoid Salt split immunofluorescence used to differentiate between EBA and BP Reference: Rooks textbook of Dermatology, 9 th Edition, Chapter 50, Page 45

Gluten is found in grains such as wheat, barley, rye, oats, triticale A gluten-free diet is a diet that excludes the gluten Reference: Rooks textbook of Dermatology, 9 th Edition, Chapter 50, Page 54

Intense pruritus and hypotension is characteristic of anaphylaxis Besides immediate onset, welling of face and respiratory distress is conclusive of Anaphylaxis Reference : Rooks textbook of dermatology, 9 th edition, chapter 43, page 4

Gluten-free diet is recommended in patients of Dermatitis herpetiformis Reference: Rooks textbook of Dermatology, 9 th Edition, Chapter 50, Page 54

Dermatitis herpetiformis is a complex disease of the skin caused by the deposition of IgA in the papillary dermis which triggers an immunologic cascade. It has no association with viral or bacterial etiology. Dermatitis herpetiformis aka Duhring's disease is commonly a/w genetic predisposition for gluten sensitivity, l/t formation of IgA antibodies against gluten-tissue transglutaminase. Reference: Rooks textbook of Dermatology, 9 th Edition, Chapter 50, Page 53

The examination finding is s/o symptomatic dermographism which is seen in chronic urticaria Prevention and avoidance of precipitating factors such as physical stimuli and stressors are important in managing dermatographism. Choice therapy includes treatment with H1 antihistamines such as cetirizine or loratadine. Reference : Rooks textbook of dermatology, 9 th edition, chapter 42, Page no 11

Erythema multiforme - manifests as very characteristic 1-2 cm circular lesions consisting of 3 concentric zones - a pinkish raised periphery, pallor in middle and a dark violaceous centre thickened to the iris of the eye or the target of the shooting range. Such a lesions are therefore called iris lesions or target lesions Some case may develop tense blister at the centre of the target lesions Approximately 90% of cases of erythema multiforme minor follow outbreaks of herpes simplex (HSV 1 infection)

10-30% - SJS-TEN complex > 30% - Toxic epidermal necrolysis (TEN) Reference: Rooks textbook of Dermatology, 9 th edition, Chapter 119, page 10