Which finding is characteristic of pemphigus vulgaris?

Which finding is characteristic of pemphigus vulgaris?

• A. Vesicular lesions on extensor surfaces without mucosal involvement
• B. Bullae only, no erosions
• C. Positive Nikolsky sign only in skin
• D. Oral mucosal erosions with fragile bullae and a positive Nikolsky sign

Answer: (D)

Pemphigus vulgaris is an autoimmune blistering disease where antibodies attack desmosomes between epidermal cells, leading to acantholysis and loss of cell-to-cell adhesion. This causes flaccid bullae that rupture easily, leaving painful erosions. A key feature is mucosal involvement, especially oral erosions, along with a Nikolsky sign that is positive on both skin and mucosa. The described finding—oral mucosal erosions with fragile bullae and a positive Nikolsky sign—best fits pemphigus vulgaris because it reflects the mucosal involvement, fragile bullae, and the positive Nikolsky sign characteristic of this condition. Other options lack mucosal involvement or describe a Nikolsky sign limited to the skin, which does not align with the typical PV presentation.

Pemphigus vulgaris is an autoimmune blistering disease where antibodies attack desmosomes between epidermal cells, leading to acantholysis and loss of cell-to-cell adhesion. This causes flaccid bullae that rupture easily, leaving painful erosions. A key feature is mucosal involvement, especially oral erosions, along with a Nikolsky sign that is positive on both skin and mucosa. The described finding—oral mucosal erosions with fragile bullae and a positive Nikolsky sign—best fits pemphigus vulgaris because it reflects the mucosal involvement, fragile bullae, and the positive Nikolsky sign characteristic of this condition. Other options lack mucosal involvement or describe a Nikolsky sign limited to the skin, which does not align with the typical PV presentation.