WBR0476
| Author | [[PageAuthor::Rim Halaby, M.D. [1], (Reviewed by Alison Leibowitz)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pathology, MainCategory::Pathophysiology |
| Sub Category | SubCategory::Musculoskeletal/Rheumatology |
| Prompt | [[Prompt::A 40-year-old female presents to her dermatologist with complaints of several skin lesions. Upon physical examination, the physician notes several intraepidermal bullae, with flaccid blisters, and an epidermal layer that easily is removed with manual stroking. Which of the following processes best characterizes the patient's disease?]] |
| Answer A | AnswerA::IgG antibodies against desmosome |
| Answer A Explanation | [[AnswerAExp::Pemphigus vulgaris results from IgG antibodies against desmosomes.]] |
| Answer B | AnswerB::IgM antibodies against desmosome |
| Answer B Explanation | [[AnswerBExp::Pemphigus vulgaris results from IgG antibodies against desmosomes, not IgM desmosomes.]] |
| Answer C | AnswerC::IgG antibodies against hemidesmosome |
| Answer C Explanation | AnswerCExp::Bullous pemphigoid results from IgG antibodies against hemidesmosomes. |
| Answer D | AnswerD::IgM antibodies against hemidesmosome |
| Answer D Explanation | [[AnswerDExp::Pemphigus vulgaris does not result from auto-antibodies against hemidesmosomes.]] |
| Answer E | AnswerE::IgE antibodies against hemidesmosome |
| Answer E Explanation | AnswerEExp::Pemphigus vulgaris does not result from auto-antibodies against hemidesmosomes. |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::Pemphigus vulgaris is an autoimmune dermatologic disease due to IgG antibodies against desmosomes, which cause acantholysis, the loss of cohesion between the keratinocytes in the epidermal layer. Pemphigus vulgaris is characterized by the manifestation of intraepidermal bullae, with flaccid blisters positive for Nicolsky's sign, the easy separation of epidermal layer upon manual stroking. Educational Objective: Pemphigus vulgaris is an autoimmune dermatological disease, resulting from IgG antibodies against desmosomes. |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::pemphigus vulgaris, WBRKeyword::IgG, WBRKeyword::antibodies, WBRKeyword::antibody, WBRKeyword::autoantibody, WBRKeyword::autoantibodies, WBRKeyword::desmosome, WBRKeyword::blisters, WBRKeyword::bullae, WBRKeyword::dermatology, WBRKeyword::skin, WBRKeyword::lesion |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |