Layers of epidermis from bottom to TOP: GeSpiGraLuciCorn
|Epidermis layers top to bottom||Full name||Condition|
|Ge||Stratum Germinativum/basal layer|
|Basement membrane||Bullous Pemphigoid|
Bullous pemphigoid is the result of an attack on the basement membrane of the epidermis by IgG +/- IgE immunoglobulins and activated T lymphocytes. Bullous pemphigoid often presents in older people. Bullous pemphigoid causes severe itching and large, tense bullae (fluid-filled blisters), which rupture forming crusted erosions.
In pemphigus vulgaris, immunoglobulin type G (IgG) autoantibodies bind to a protein called desmoglein 3 (dsg3), which is found in desmosomes [keratinocytes are cemented together at spots called desmosomes] in the keratinocytes near the bottom of the epidermis. This caused flaccid bullae and involves mucous membranes more often. Nikolsky’s sign positive. Acanthocytes on Tzanck smear are seen.
Both the above conditions are treated with Steroids [Topical and Systemic] and Non Steroidal Immunomodulators.