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A 62 year old man presents with a
6-week history of itchy blistering rash occurring
on the trunk and limbs (see below). He is
otherwise in good health apart from controlled
hypertension. His medications are ramipril and
aspirin. On examination he has several tense,
clear and haemorrhagic-fluid filled blisters
arising on erythematous plaques on the trunk
and limbs. A diagnosis of bullous pemphigoid is suspected
Which of the following would you expect
to find?
A. Mucosal involvement
B. Neutrophilia
C. Positive circulating anti-epidermal antibodies
D. Positive Nikolsky sign
E. Subcorneal blister on histology
1 406
A 22 year old pregnant woman presents
to her family physician at 32 weeks’ gestation
with a 1-week history of intense generalised
pruritus, which is preventing her from sleeping.
Her family physician examines her and finds no
abnormalities.
Which of the following would be the most
important investigation to undertake?
1 406
A 50-year-old male presents to the dermatology clinic with persistent, painful ulcers in the oral cavity. He states that the ulcers started several weeks ago and have made it difficult for him to eat. He denies fever or weight loss. Physical examination shows erosions on the buccal mucosa and gingiva. There are no obvious skin lesions at this stage. Which of the following is the most likely diagnosis?
A. Aphthous stomatitis
B. Herpes simplex infection
C. Pemphigus vulgaris
D. Oral candidiasis
E. Lichen planus
1 406
A 52-year-old woman presents with painful erosions on her face and scalp. She reports that the lesions began as flaccid blisters that ruptured easily, leaving raw areas. On examination, there are large erosions and some erythematous patches. Gentle lateral pressure applied to the skin near an erosion causes the epidermis to shear away.
Which of the following clinical signs is being demonstrated in this patient?
A. Koebner phenomenon
B. Nikolsky sign
C. Auspitz sign
D. Darier sign
E. Pathergy test
1 406
A 45-year-old male presents with multiple painful erosions in the oral mucosa and flaccid bullae on the skin that rupture easily. A skin biopsy shows acantholysis and immunofluorescence reveals IgG deposits in a “fishnet” pattern. The patient recently started taking medication for hypertension and rheumatoid arthritis.
Which of the following medications is most likely associated with this condition?
A. Atenolol
B. Methotrexate
C. Captopril
D. Metformin
E. Paracetamol
1 406
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