Vesiculobullous disorders: pemphigus erythematosus: 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 erythematosus

Sample item

A woman has crusted, scaly erythematous plaques over the malar area and seborrhoeic zones of the chest and scalp, with a few superficial erosions. DIF shows intercellular IgG in the epidermis and granular IgG with C3 at the basement membrane, and ANA is positive. What is the diagnosis?

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

The answer and the reasoning

B. Pemphigus erythematosus

Pemphigus erythematosus (Senear-Usher syndrome) is a localised form of pemphigus foliaceus with a lupus-like malar distribution. DIF shows both intercellular IgG, as in pemphigus, and a lupus band at the basement membrane, and ANA may be positive. Treatment follows pemphigus foliaceus.

Option by option

  • A. Systemic lupus erythematosus with bullae

    Bullous SLE has no intercellular IgG and shows linear antibodies at the basement membrane.

  • B. Pemphigus erythematosus (correct)

    Correct. Intercellular IgG with a lupus band and ANA in a seborrhoeic and malar distribution defines Senear-Usher syndrome.

  • C. Pemphigus vulgaris

    Pemphigus vulgaris causes deep mucosal erosions and flaccid blisters without a lupus band.

  • D. Seborrhoeic dermatitis

    Seborrhoeic dermatitis has negative immunofluorescence.

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.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is B, Pemphigus erythematosus. Pemphigus erythematosus (Senear-Usher syndrome) is a localised form of pemphigus foliaceus with a lupus-like malar distribution.

Why is "Systemic lupus erythematosus with bullae" not the answer?

Bullous SLE has no intercellular IgG and shows linear antibodies at the basement membrane.

Why is "Pemphigus vulgaris" not the answer?

Pemphigus vulgaris causes deep mucosal erosions and flaccid blisters without a lupus band.

Why is "Seborrhoeic dermatitis" not the answer?

Seborrhoeic dermatitis has negative immunofluorescence.

What concept does this question test?

It tests Vesiculobullous disorders: pemphigus erythematosus in Dermatology. DIF shows both intercellular IgG, as in pemphigus, and a lupus band at the basement membrane, and ANA may be positive. Treatment follows pemphigus foliaceus.

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: pemphigus erythematosus?

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.