Bullous disorders: 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

Sample item

A positive Nikolsky sign is characteristic of:

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

The answer and the reasoning

A. Pemphigus vulgaris

Nikolsky's sign, where gentle lateral pressure causes the epidermis to slip off, reflects intraepidermal acantholysis in pemphigus vulgaris. It is also seen in toxic epidermal necrolysis and staphylococcal scalded skin syndrome. Bullous pemphigoid has tense bullae and a negative sign.

Option by option

  • A. Pemphigus vulgaris (correct)

    Correct. Loss of cell adhesion between keratinocytes makes the epidermis slide.

  • B. Psoriasis

    Psoriasis shows scaly plaques without epidermal sliding.

  • C. Bullous pemphigoid

    Bullous pemphigoid has subepidermal blisters and a negative Nikolsky sign.

  • D. Lichen planus

    Lichen planus shows violaceous papules.

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, Pemphigus vulgaris. Nikolsky's sign, where gentle lateral pressure causes the epidermis to slip off, reflects intraepidermal acantholysis in pemphigus vulgaris.

Why is "Psoriasis" not the answer?

Psoriasis shows scaly plaques without epidermal sliding.

Why is "Bullous pemphigoid" not the answer?

Bullous pemphigoid has subepidermal blisters and a negative Nikolsky sign.

Why is "Lichen planus" not the answer?

Lichen planus shows violaceous papules.

What concept does this question test?

It tests Bullous disorders in Dermatology. It is also seen in toxic epidermal necrolysis and staphylococcal scalded skin syndrome. Bullous pemphigoid has tense bullae and a negative sign.

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?

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.