Vesiculobullous disorders: paraneoplastic pemphigus antigens: 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: paraneoplastic pemphigus antigens

Sample item

A 62-year-old with non-Hodgkin lymphoma has intractable painful stomatitis and polymorphic skin lesions with blisters and target-like lesions. Indirect immunofluorescence on rat bladder epithelium is positive. Which antigens are characteristically targeted?

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

The answer and the reasoning

D. Envoplakin and periplakin

Paraneoplastic pemphigus is associated with lymphoproliferative disease, thymoma and Castleman disease, and the antibodies target plakins such as envoplakin, periplakin and desmoplakin along with desmogleins. Positive staining of rat bladder epithelium is a clue. Severe mucositis and bronchiolitis obliterans are typical.

Option by option

  • A. Type VII collagen

    Type VII collagen is the target in epidermolysis bullosa acquisita.

  • B. Tissue transglutaminase

    Tissue transglutaminase relates to coeliac disease and dermatitis herpetiformis via epidermal transglutaminase.

  • C. BP180 only

    BP180 is the target in bullous pemphigoid.

  • D. Envoplakin and periplakin (correct)

    Correct. Envoplakin and periplakin are characteristic targets.

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 D, Envoplakin and periplakin. Paraneoplastic pemphigus is associated with lymphoproliferative disease, thymoma and Castleman disease, and the antibodies target plakins such as envoplakin, periplakin and desmoplakin along with desmogleins.

Why is "Type VII collagen" not the answer?

Type VII collagen is the target in epidermolysis bullosa acquisita.

Why is "Tissue transglutaminase" not the answer?

Tissue transglutaminase relates to coeliac disease and dermatitis herpetiformis via epidermal transglutaminase.

Why is "BP180 only" not the answer?

BP180 is the target in bullous pemphigoid.

What concept does this question test?

It tests Vesiculobullous disorders: paraneoplastic pemphigus antigens in Dermatology. Positive staining of rat bladder epithelium is a clue. Severe mucositis and bronchiolitis obliterans are typical.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: paraneoplastic pemphigus antigens?

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.