Which of the following statements regarding bullous pemphigoid is true?
A. The condition is most common in patients older than 60 years
B. The condition often begins in the mouth
C. Prior to the advent of corticosteroids the disease was often fatal
D. Ocular involvement may often lead to symblepharon or blindness
E. Skin lesions often heal with scarring or milia
A. Patients with bullous pemphigoid are typically older (> 60 years old) with comorbidities. Unlike pemphigus, most cases of bullous pemphigoid do not begin in the mucosa. Prior to the advent of systemic corticosteroids, it was pemphigus vulgaris that was often fatal. Ocular involvement leading to symblepharon is more common in cicatricial pemphigoid. Epidermolysis bullosa acquisita heals with scarring and milia.
In linear IgA bullous dermatosis, DIF examination of perilesional skin most often demonstrates:
A. IgA deposition in a linear band along the dermoepidermal junction
B. IgA deposition in a granular pattern intermittently within the papillary dermis
C. IgG accumulation in a net-like pattern in the epidermis
D. IgG accumulation in a linear band along the dermoepidermal junction
E. C3 accumulation in a granular pattern along the dermoepidermal junction
A. In linear IgA bullous dermatosis, DIF most often reveals linear deposition of IgA along the dermoepidermal junction. Similarly linear deposition of linear IgG and C3 deposition is more common in bullous pemphigoid. Intermittent and course deposition of IgA in the papillary dermis is more common in dermatitis herpetiformis. Net-like intraepidermal deposition of immunoreactants is seen in pemphigus.
The Brunsting-Perry variant of cicatricial pemphigoid most often involves what type of patient?
E. An elderly person of either sex
C. The Brunsting-Perry variant of cicatricial pemphigoid most often affects the scalp of elderly men. For this reason, it may often be confused with non-melanoma skin cancer.
IIF examination of salt-split skin demonstrates deposition of immunoreactants along the roof of the blister cavity in:
A. Anti-epiligrin cicatricial pemphigoid