Mucous Membrane Pemphigoid — MFDS Part 1 MCQ

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ModerateOral PathologyMucous Membrane PemphigoidMFDS Part 1

On routine histopathological examination of an intact oral lesion in mucous membrane pemphigoid, at which level is the vesicle or bulla formed?

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Correct answer: B — Subepithelially, at the basement membrane zone

Explanation lettering: E = shown as A · A = shown as B · B = shown as E

The correct answer is A. Mucous membrane pemphigoid is an autoimmune subepithelial blistering disorder. Autoantibodies target structural proteins associated with hemidesmosomes and the basement membrane zone, causing the full epithelial layer to separate from the underlying connective tissue. A suprabasal intraepithelial split (B) is characteristic of pemphigus vulgaris, whereas a subcorneal split (C) is associated with pemphigus foliaceus and is rarely relevant to oral mucosa. Separation does not arise within the connective tissue (D) or within the basal cell layer (E). Direct immunofluorescence typically demonstrates linear immunoreactant deposition along the basement membrane zone.

Reference: Schmidt E, Patzelt S. Immunopathogenesis of mucous membrane pemphigoid. Ophthalmologie. 2023;120(5):462–471. https://pubmed.ncbi.nlm.nih.gov/37129642/