Vesiculobullous disorders: pemphigus vegetans: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Vesiculobullous disorders: pemphigus vegetans

Sample item

A patient has vegetating, papillomatous plaques with pustules in the axillae and groins that evolved from flaccid erosions. DIF shows intercellular IgG. Which variant of pemphigus is this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Pemphigus vegetans

Pemphigus vegetans is a rare variant of pemphigus vulgaris with vegetating plaques in flexures such as the axillae, groins and under the breasts. Autoantibodies target desmogleins, and DIF shows an intercellular IgG pattern. Treatment follows that for pemphigus vulgaris.

Option by option

  • A. Pemphigus erythematosus

    Pemphigus erythematosus shows malar and seborrhoeic distribution with lupus-like features.

  • B. Pemphigus foliaceus

    Pemphigus foliaceus has superficial crusted erosions on seborrhoeic areas and no mucosal disease.

  • C. Pemphigus vegetans (correct)

    Correct. Vegetating flexural plaques that evolve from erosions indicate pemphigus vegetans.

  • D. Paraneoplastic pemphigus

    Paraneoplastic pemphigus has severe stomatitis with an underlying neoplasm.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Pemphigus vegetans. Pemphigus vegetans is a rare variant of pemphigus vulgaris with vegetating plaques in flexures such as the axillae, groins and under the breasts.

Why is "Pemphigus erythematosus" not the answer?

Pemphigus erythematosus shows malar and seborrhoeic distribution with lupus-like features.

Why is "Pemphigus foliaceus" not the answer?

Pemphigus foliaceus has superficial crusted erosions on seborrhoeic areas and no mucosal disease.

Why is "Paraneoplastic pemphigus" not the answer?

Paraneoplastic pemphigus has severe stomatitis with an underlying neoplasm.

What concept does this question test?

It tests Vesiculobullous disorders: pemphigus vegetans in Dermatology. Autoantibodies target desmogleins, and DIF shows an intercellular IgG pattern. Treatment follows that for pemphigus vulgaris.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vesiculobullous disorders: pemphigus vegetans?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.