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Dermatological Examination of Bullous Diseases

  • Marcel F. JonkmanEmail author
Chapter

Abstract

Physical examination in bullous diseases always comprises looking at the skin and mucous membranes. Examine the skin not only for the presence of vesicles or bullae but also for other efflorescences. Nikolsky’s, Sheklakov’s, and Asboe-Hansen’s signs test the resilience of the skin. The mucous membranes of the mouth, nose, eyes, and genitals need to be examined systematically. Disease activity and extent of the skin and mucous membranes can be assessed using disease activity outcome measures that are validated for pemphigus, bullous pemphigoid, and mucous membrane pemphigoid.

Keywords

Nikolsky’s sign Disease activity Autoimmune disease Vesiculobullous disease 

References

  1. 1.
    Grando SA, Grando AA, Glukhenky BT, Doguzov V, Nguyen VT, Holubar K. History and clinical significance of mechanical symptoms in blistering dermatoses: a reappraisal. J Am Acad Dermatol. 2003;48:86–92.Google Scholar
  2. 2.
    Mignogna MD, Fortuna G, Leuci S, Ruoppo E, Marasca F, Matarasso S. Nikolsky’s sign on the gingival mucosa: a clinical tool for oral health practitioners. J Periodontol. 2008;79:2241–6.Google Scholar
  3. 3.
    Murrell DF, Dick S, Ahmed AR, Amagai M, Barnadas MA, Borradori L, Bystryn JC, Cianchini G, Diaz L, Fivenson D, Hall R, Harman KE, Hashimoto T, Hertl M, Hunzelmann N, Iranzo P, Joly P, Jonkman MF, Kitajima Y, Korman NJ, Martin LK, Mimouni D, Pandya AG, Payne AS, Rubenstein D, Shimizu H, Sinha AA, Sirois D, Zillikens D, Werth VP. Consensus statement on definitions of disease, end points, and therapeutic response for pemphigus. J Am Acad Dermatol. 2008;58:1043–6.Google Scholar
  4. 4.
    Rosenbach M, Murrell DF, Bystryn JC, Dulay S, Dick S, Fakharzadeh S, Hall R, Korman NJ, Lin J, Okawa J, Pandya AG, Payne AS, Rose M, Rubenstein D, Woodley DT, Vittorio C, Werth BB, Williams EA, Taylor L, Troxel AB, Werth VP. Reliability and convergent validity of two outcome instruments for pemphigus. J Invest Dermatol. 2009;129:2404–10.Google Scholar
  5. 5.
    Murrell DF, Daniel BS, Joly P, Borradori L, Amagai M, Hashimoto T, Caux F, Marinovic B, Sinha AA, Hertl M, Bernard P, Sirois D, Cianchini G, Fairley JA, Jonkman MF, Pandya AG, Rubenstein D, Zillikens D, Payne AS, Woodley DT, Zambruno G, Aoki V, Pincelli C, Diaz L, Hall RP, Meurer M, Mascaró JM, Schmidt E, Shimizu H, Zone JJ, Swerlick R, Mimouni D, Culton D, Lipozencic J, Bince B, Grando SA, Bystryn JC, Werth VP. Definitions and outcome measures for bullous pemphigoid: recommendations by an international panel of experts. J Am Acad Dermatol. 2012;66:479–85.Google Scholar
  6. 6.
    Murrell DF, Marinovic B, Caux F, Prost C, Ahmed R, Wozniak K, Amagai M, Bauer JW, Beissert S, Borradori L, Culton D, Fairley JA, Fivenson D, Jonkman MF, Marinkovich MP, Woodley DT, Zone JJ, Aoki V, Bernard P, Bruckner-Tuderman L, Cianchini G, Venning VA, Diaz L, Eming R, Grando SA, Hall RP, Hashimoto T, Herrero-González JE, Hertl M, Joly P, Kárpáti S, Kim J, Chan Kim S, Korman NJ, Kowalewski C, LEE SE, Rubenstein DR, Sprecher E, Yancey KB, Zambruno G, Zillikens D, Doan S, Daniel BS, Werth VP. Definitions and outcome measures for mucous membrane pemphigoid: Recommendations of an international panel of experts. J Am Acad Dermatol. 2015;72:168–74.Google Scholar

Additional Reading

  1. Powell AM, Black M. A stepwise approach to the diagnosis of blisters in the clinic. Clin Dermatol. 2001;19:598–606.CrossRefPubMedGoogle Scholar

On the Web

  1. International Pemphigus and Pemphigoid Foundation. http://www.pemphigus.org/.

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of DermatologyCenter for Blistering Diseases, University Medical Center Groningen, University of GroningenGroningenthe Netherlands

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