Bullous disorders: bullous pemphigoid: 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 · Bullous disorders: bullous pemphigoid

Sample item

An 80-year-old has tense blisters on flexural surfaces after preceding itchy urticated plaques, and biopsy shows a subepidermal blister with eosinophils. Which antigens are targeted?

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

The answer and the reasoning

A. BP180 and BP230 of hemidesmosomes

Bullous pemphigoid is the commonest autoimmune subepidermal blistering disease in the elderly, with IgG against BP180 (collagen XVII) and BP230. Direct immunofluorescence shows linear IgG and C3 along the basement membrane.

Option by option

  • A. BP180 and BP230 of hemidesmosomes (correct)

    Correct. Hemidesmosomal BP180 and BP230 are the targets.

  • B. Desmoglein 1 and 3

    Desmogleins are the targets in pemphigus.

  • C. Collagen VII

    Collagen VII is the target in EBA.

  • D. Transglutaminase 3

    Transglutaminase 3 is the main antigen in dermatitis herpetiformis.

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 A, BP180 and BP230 of hemidesmosomes. Bullous pemphigoid is the commonest autoimmune subepidermal blistering disease in the elderly, with IgG against BP180 (collagen XVII) and BP230.

Why is "Desmoglein 1 and 3" not the answer?

Desmogleins are the targets in pemphigus.

Why is "Collagen VII" not the answer?

Collagen VII is the target in EBA.

Why is "Transglutaminase 3" not the answer?

Transglutaminase 3 is the main antigen in dermatitis herpetiformis.

What concept does this question test?

It tests Bullous disorders: bullous pemphigoid in Dermatology. Direct immunofluorescence shows linear IgG and C3 along the basement membrane.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Bullous disorders: bullous pemphigoid?

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.