A 65-year-old diabetic man presents with tense blisters over the abdomen and thighs on an urticarial base. Nikolsky sign is negative. DIF shows linear IgG and C3 at the dermoepidermal junction. Anti-BP180 and anti-BP230 antibodies are elevated. What is the correct diagnosis?

• A Pemphigus vulgaris
• B Epidermolysis bullosa acquisita
• C Linear IgA bullous dermatosis
• D Bullous pemphigoid ✓

Explanation

Bullous pemphigoid is the most common autoimmune bullous disorder in the elderly. It is characterized by tense blisters on an erythematous or urticarial base, negative Nikolsky sign, and subepidermal blister formation. DIF shows linear IgG and C3 at the basement membrane zone, and target antigens are BP180 (type XVII collagen) and BP230 (BPAG1). Unlike pemphigus, mucosal involvement is uncommon and the blisters are tense due to the deeper cleavage plane.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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