Question
Statement 1 – A 59-year-old patient presents with flaccid bullae. Histopathology shows a suprabasal acantholytic split.
Statement 2 – The row of tombstones appearance is diagnostic of Pemphigus vulgaris.
Which of the following statements is correct?
| A. |
Statement 1 is incorrect
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| B. |
Statements 1 & 2 are correct, 2 is not explaining 1
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| C. |
Statement 1 and 2 is incorrect
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| D. |
Statements 1 and 2 are correct and 2 is the correct explanation for 1
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Show Answer
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Correct Answer » D
Explanation
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Pemphigus vulgaris is an autoimmune blistering disorder characterized by:
- Flaccid intraepidermal bullae
- Acantholysis (loss of intercellular connections between keratinocytes)
- Suprabasal split on histopathology
It commonly affects:
- Middle-aged and elderly individuals
- Skin and oral mucosa
Explanation of Statement 1
Statement 1: Correct
Clinical findings:
- Flaccid bullae are characteristic of pemphigus vulgaris.
- Histopathology classically shows:
- Suprabasal acantholytic cleft/split
- Separation occurs just above the basal layer
Reason:
- Autoantibodies against desmoglein 3 (and sometimes desmoglein 1)
- Causes loss of keratinocyte adhesion
Explanation of Statement 2
Statement 2: Correct
“Row of tombstones” appearance:
- Basal keratinocytes remain attached to the basement membrane
- Upper epidermal cells separate due to acantholysis
- Remaining basal cells resemble a row of tombstones microscopically
This is a classic histopathological feature of pemphigus vulgaris.
Why Statement 2 Explains Statement 1
- Suprabasal acantholysis leads to retention of basal cells attached to the basement membrane.
- This creates the characteristic “row of tombstones” appearance.
- Therefore, Statement 2 directly explains the histopathological finding mentioned in Statement 1.
Hence:
- Both statements are correct
- Statement 2 correctly explains Statement 1
