Module M: Vesiculobullous Diseases

This module focuses on blistering disorders, including pemphigus, bullous pemphigoid, and related conditions. Key topics include the structure and function of the basement membrane zone, diagnostic techniques, such as direct immunofluorescence, and the pathophysiology and treatment of these disorders. Providers will also learn to recognize rarer conditions like cicatricial pemphigoid and epidermolysis bullosa acquisita (EBA), ensuring a comprehensive approach to diagnosis and management.

2 CME credits

After participating in this module, the learner will be able to:

Section 1: Pemphigus, Bullous Pemphigoid, and Related Disorders

1. Explain the structure of the basement membrane zone, function of desmosomes and hemidesmosomes, and cell to cell adhesion as it correlates to blistering disorders.
2. Explain the procedure for proper use and biopsy technique of Direct Immunofluorescence and interpretation of results associated with blistering disorders as well as procedure and use of salt split skin.
3. Explain the presentation, pathophysiology, interpretation of H&E and direct immunofluorescence, causes, and treatment of pemphigus vulgaris and pemphigus foliaceus.
4. Describe the presentation of bullous pemphigoid, have a basic understanding of pathophysiology, recognize pathological description (on both H&E and DIF), and be able to discuss treatment options.
5. Recognize cicatricial pemphigoid, epidermolysis bullosa acquisita, and paraneoplastic pemphigus.

Section 2: Other Vesiculobullous Diseases

1. Explain the epidemiology, presentation, and basic pathophysiology, order appropriate diagnostic tests (biopsy and labs), formulate a treatment plan, and educate patients on dermatitis herpetiformis.
2. Explain the dietary considerations in the treatment of dermatitis herpetiformis.
3. Be able to recognize linear IgA disease and its variants/causes, formulate a differential diagnosis, explain the histology associated with this disorder, and describe potential treatments and patient education.
4. Explain the various types of epidermolysis bullosa (including EB simplex, junctional EB, dystrophic EB, and Kindler syndrome), their inheritance patterns, presentation, clinical features, and diagnosis, and formulate comprehensive treatment plans.
5. Have a good understanding of the importance of wound management, patient education, and support necessary in the treatment of epidermolysis bullosa.
6. Recognize the presentation of disorders associated with vesicles and/or bullae and formulate differential diagnoses and treatments.

*Previously known as Module 15 in the Diplomate Fellowship

This module and others will be released on a rolling basis through the remainder of 2025.