In bullous pemphigoid, the autoantibodies that correlate best with disease activity are directed against which region?

• A The intracellular domain of BP180
• B The NC16A extracellular domain of BP180 (type XVII collagen) ✓
• C BP230 (plectin), the cytoplasmic plaque component
• D Type VII collagen within the sublamina densa

Explanation

Anti-BP180 antibodies, particularly against the membrane-proximal NC16B ectodomain, are found in the majority of patients and their titres parallel disease activity. Antibodies to BP230 occur in a subset and are not reliably correlated with activity because the antigen sits inside the keratinocyte and is less accessible. Type VII collagen is the target in epidermolysis bullosa acquisita, not bullous pemphigoid.

Reference: Bolognia, Schaffer and Cerroni, Dermatology, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.