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Pemphigus vulgaris — NDEB AFK MCQ

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HardOral PathologyPemphigus vulgarisNDEB AFK

A 50-year-old has painful widespread oral erosions that began as fragile bullae. Gentle lateral pressure on normal-appearing mucosa produces epithelial sloughing. Skin lesions are starting to appear. What is the most likely diagnosis?

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Correct answer: E — Pemphigus vulgaris

Fragile bullae, widespread erosions, and a positive Nikolsky-type response are classic for pemphigus vulgaris. Mucous membrane pemphigoid tends to produce more resilient subepithelial bullae and often affects gingiva and other mucosae. The pearl is that suspected autoimmune vesiculobullous disease requires biopsy with immunofluorescence and medical coordination.

Reference: Canadian oral medicine reference texts; NDEB KSAs 2024