Which of the following pemphigus variants is characterized by IgG4 subclass predominance against desmoglein-1 only, with superficial subcorneal blistering and no mucosal involvement?
- A Pemphigus foliaceus ✓
- B Pemphigus vulgaris
- C Pemphigus vegetans
- D Pemphigus erythematosus
Correct answer: A. Pemphigus foliaceus
Explanation
Pemphigus foliaceus has antibodies exclusively against desmoglein-1 (160 kDa). Since Dsg1 is expressed only in superficial epidermis and is absent from mucosae (where Dsg3 compensates), mucosal involvement is absent. The split is subcorneal/granular layer. IgG4 subclass predominates. Pemphigus vulgaris targets Dsg3 (and Dsg1 in mucocutaneous type). Pemphigus vegetans is a variant of PV. Pemphigus erythematosus (Senear-Usher) combines features of foliaceus and lupus.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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