BOF: 44
A 50-year-old male presents with oral ulceration, and
flaccid blisters on the skin especially the trunk. The blisters are sore but not
itchy and they rapidly denude leaving weeping, erythematous erosions. Gentle
sliding pressure on the blisters makes them extend. In this condition:
a)
Low dose steroids are effective in controlling formation of new blisters
b)
Local steroids are effective in controlling the disease
c)
Long term tetracycline is effective treatment
d)
Gold may be effective therapy in steroid resistant patients
e)
Dapsone is effective on controlling the disease
Answer:
d)
The patient has pemphigus vulgaris. The physical sign
described is Nikolsky's sign( extension of the blister with pressure). In
pemphigus vulgaris high dose steroids may be needed to prevent formation of new
blisters. Azathioprine and methotrexate may be needed to reduce the dose of
steroids. Gold may be effective in steroid resistant patients.
