Vesiculobullous disorders: IgA pemphigus: 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: IgA pemphigus

Sample item

A 50-year-old has flaccid pustules arranged in rings on the trunk and flexures. Biopsy shows subcorneal neutrophils with little acantholysis. Direct immunofluorescence shows IgA deposited between keratinocytes. What is the diagnosis?

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

The answer and the reasoning

B. IgA pemphigus

IgA pemphigus is an intraepidermal neutrophilic dermatosis with intercellular IgA on direct immunofluorescence. Dapsone is the usual first-line treatment.

Option by option

  • A. Dermatitis herpetiformis

    Dermatitis herpetiformis shows granular IgA at the papillary dermal tips.

  • B. IgA pemphigus (correct)

    Correct. Intercellular IgA with subcorneal pustules is IgA pemphigus.

  • C. Subcorneal pustular dermatosis

    Subcorneal pustular dermatosis looks similar but direct immunofluorescence is negative.

  • D. Pemphigus foliaceus

    Pemphigus foliaceus shows intercellular IgG and C3 with acantholysis.

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 B, IgA pemphigus. IgA pemphigus is an intraepidermal neutrophilic dermatosis with intercellular IgA on direct immunofluorescence.

Why is "Dermatitis herpetiformis" not the answer?

Dermatitis herpetiformis shows granular IgA at the papillary dermal tips.

Why is "Subcorneal pustular dermatosis" not the answer?

Subcorneal pustular dermatosis looks similar but direct immunofluorescence is negative.

Why is "Pemphigus foliaceus" not the answer?

Pemphigus foliaceus shows intercellular IgG and C3 with acantholysis.

What concept does this question test?

It tests Vesiculobullous disorders: IgA pemphigus in Dermatology. Dapsone is the usual first-line treatment.

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: IgA pemphigus?

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.