WBR0476

Author	[[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pathology, MainCategory::Pathophysiology
Sub Category	SubCategory::Musculoskeletal/Rheumatology
Prompt	[[Prompt::A 40 year old female patient presents to her dermatologist complaining of several skin lesions. On physical examination, the physician notes several intraepidermal bullae with flaccid blisters and an epidermal layer that easily comes off with manual stroking. Which of the following processes characterize the disease in this patient?]]
Answer A	AnswerA::IgG antibodies against desmosome
Answer A Explanation	AnswerAExp::Pemphigus vulgaris is characterized by IgG antibodies against desmosome.
Answer B	AnswerB::IgM antibodies against desmosome
Answer B Explanation	AnswerBExp::Pemphigus vulgaris is characterized by IgG antibodies against desmosome, not IgM desmosome.
Answer C	AnswerC::IgG antibodies against hemidesmosome
Answer C Explanation	AnswerCExp::Bullous pemphigoid is characterized by IgG antibodies against hemidesmosome
Answer D	AnswerD::IgM antibodies against hemidesmosome
Answer D Explanation	AnswerDExp::Pemphigus vulgaris is not due to auto-antibodies against hemidesmosome
Answer E	AnswerE::IgE antibodies against hemidesmosome
Answer E Explanation	AnswerEExp::Pemphigus vulgaris is not due to auto-antibodies against hemidesmosome
Right Answer	RightAnswer::A
Explanation	[[Explanation::Pemphigus vulgaris is an autoimmune dermatologic disease due to IgG antibodies against desmosomes that causes acantholysis, defined as loss of cohesion between the keratinocytes in the epidermal layer. Pemphigus vulgaris is characterized by formation of intraepidermal bullae that cause flaccid blisters with positive Nicolsky's sign, defined as easy separation of epidermal layer upon manual stroking. Educational Objective: Pemphigus vulgaris is an autoimmune dermatological disease characterized by IgG antibody against desmosome. Educational Objective: References: ]]
Approved	Approved::No
Keyword	WBRKeyword::pemphigus, WBRKeyword::vulgaris, WBRKeyword::pemphigus vulgaris, WBRKeyword::IgG, WBRKeyword::auto, WBRKeyword::antibodies, WBRKeyword::antibody, WBRKeyword::autoantibody, WBRKeyword::autoantibodies, WBRKeyword::desmosome, WBRKeyword::blisters, WBRKeyword::blisters, WBRKeyword::bullae, WBRKeyword::acantholysis, WBRKeyword::nicolsky's, WBRKeyword::nicolsky
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::