Oral medicine and oral cancer: mucous membrane pemphigoid: practice question

A Dentistry 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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Dentistry · Oral medicine and oral cancer: mucous membrane pemphigoid

Sample item

A 70-year-old woman has desquamative gingivitis and a gritty red eye with early conjunctival scarring. Biopsy shows a subepithelial split, and direct immunofluorescence shows linear IgG and C3 along the basement membrane zone. What is the diagnosis?

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

The answer and the reasoning

D. Mucous membrane pemphigoid

Mucous membrane pemphigoid is an autoimmune subepithelial blistering disease with linear IgG or C3 deposition at the basement membrane zone; it favours gingiva and eyes, where scarring can cause symblepharon and blindness. In pemphigus the split is intraepithelial with intercellular deposits.

Option by option

  • A. Erosive lichen planus

    Erosive lichen planus shows a band-like infiltrate and shaggy fibrinogen at the basement membrane.

  • B. Linear IgA disease

    Linear IgA disease has linear IgA, not IgG and C3.

  • C. Pemphigus vulgaris

    Pemphigus vulgaris shows intraepithelial acantholysis with a fishnet intercellular pattern.

  • D. Mucous membrane pemphigoid (correct)

    Correct. A subepithelial split with linear basement membrane deposits and ocular scarring is mucous membrane pemphigoid.

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 Dentistry question

What is the answer to this Dentistry question?

The best answer is D, Mucous membrane pemphigoid. Mucous membrane pemphigoid is an autoimmune subepithelial blistering disease with linear IgG or C3 deposition at the basement membrane zone; it favours gingiva and eyes, where scarring can cause symblepharon and blindness.

Why is "Erosive lichen planus" not the answer?

Erosive lichen planus shows a band-like infiltrate and shaggy fibrinogen at the basement membrane.

Why is "Linear IgA disease" not the answer?

Linear IgA disease has linear IgA, not IgG and C3.

Why is "Pemphigus vulgaris" not the answer?

Pemphigus vulgaris shows intraepithelial acantholysis with a fishnet intercellular pattern.

What concept does this question test?

It tests Oral medicine and oral cancer: mucous membrane pemphigoid in Dentistry. In pemphigus the split is intraepithelial with intercellular deposits.

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 Oral medicine and oral cancer: mucous membrane pemphigoid?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry 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.