A 65-year-old man on oral furosemide develops multiple tense blisters on an erythematous base on the flexor surfaces. DIF of perilesional skin shows linear C3 and IgG at the DEJ. ELISA confirms antibodies against the NC16A domain of BP180. This is classic for:
- A Pemphigus vulgaris
- B Bullous pemphigoid ✓
- C Epidermolysis bullosa acquisita
- D Dermatitis herpetiformis
Correct answer: B. Bullous pemphigoid
Explanation
This is bullous pemphigoid (BP), the most common autoimmune blistering disorder in the elderly. Tense blisters (subepidermal cleavage) on an urticated or erythematous base, linear IgG/C3 at the DEJ on DIF, and anti-BP180 NC16A domain antibodies are its hallmarks. Furosemide, nifedipine, and rosiglitazone are known triggers. Anti-C-terminus (non-NC16A) BP180 antibodies occur in MMP. EBA targets the C-terminus of type VII collagen; DH shows granular IgA in papillary dermis.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.