Question
A 85-year-old woman has large blistering lesions on the abdomen and thighs that come and go without therapy. Nikolsky’s sign is negative. Which of the following is the most likely diagnosis?
| A. |
pemphigus vulgaris (PV)
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| B. |
dermatitis herpetiformis (DH)
|
| C. |
bullous pemphigoid
|
| D. |
erythema multiforme
|
Show Answer
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Correct Answer � C
Explanation
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|
Ans. (C)
There are antibodies to the skin basement membrane, but unlike pemphigus, antibody
levels do not correlate with disease activity.
Bullous pemphigoid is most common in the elderly, and the disease often starts with
urticaria-like and pruritic erythematous lesions, before classic blisters occur. The blisters arise from inflamed and normal skin, unlike in pemphigus where they arise from normal skin. As well, unlike pemphigus, mucosal lesions are minimal or absent.
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