CASO

Anamnesi: Uomo di 70 anni si presenta dal medico di medicina generale perché accusa ormai da due mesi la presenza di placche orticarioidi al tronco pruriginose cui, da alcune settimane, si accompagnano formazioni bollose. Il paziente soffre di una ipertensione idiopatica ed assume diuretici

Elaborare ed argomentare un’ipotesi diagnostica valida

SOLUZIONE

Diagnosi:  PEMFIGOIDE BOLLOSO

Descrizione del caso: Il pemfigoide bolloso è definito una malattia bollosa tipicamente autoimmune causata da autoreattività anticorpale IgG contro antigeni emidesmosomiali del collageno quali BPAG1 e BPAG2 e richiamo di neutrofili ed eosinofili. I neutrofili a livello della giunzione dermo-epidermica infiltano in ‘fila indiana’ e sono tra i principale mediatori della formazione della bolla insieme all’accumulo di depositi di IgG sulla membrana basale. In generale le bolle del pemfigoide bolloso appaiono a contenuto sieroso e si differiscono da quelle del pemfigo per la difficoltà di rottura. Questo perché a differenza delle bolle del pemfigo che sono molto superficiali le bolle del pemfigoide sono SUBEPIDERMICHE. La malattia ha eziologia sconosciuta anche se si associata a patologie autoimmuni, ad alcune reazioni da farmaci e neoplasie. In genere il pemfigoide bolloso colpisce gli anziani ed il trattamento prevede steroidi

Redazione | Nato a Torre del greco il 27/03/1992 5°anno facoltà di medicina e chirurgia Federico II Napoli Appassionato di molte discipline diverse la medicina rappresenta sicuramente la più importante. Non disdegno alcun settore ma le branche che più mi interessano sono quelle della diagnostica clinica, della dermatologia, della ricerca oncologica, della farmacologia, della pediatria e della medicina interna. La mia idea di medico è quella di un lavoro di gruppo che possa essere parte di un team multidisciplinare ben strutturato che garantisca ai pazienti un iter di cura completo ed efficace. Spero un giorno di poter fare esperienze anche in zone di guerra specialmente in medio oriente magari con MSF o Emergency

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