Repeated USMLE Questions Step 1- 211

A 72 year-old man complains of itchy skin lesions in the axilla, groin and medial aspect of the thigh. Examination reveals pruritic lesions and bullae in the areas mentioned above and on forearms and lower legs. There are also painful oral lesions. There is no eye involvement and Nikolsky sign is negative.

What is the most likely diagnosis?

A-Pemphigus vulgaris

B-Bullous pemphigoid

C-Cicatricial pemphigoid

D-Scabies

E-Dermatitis herpetiformis






Answer

This lesion is most likely bullous pemphigoid. Painful oral lesions and negative Nikolsky sign besides the sites of the lesions confirm the diagnosis.

The correct answer is B