I always forget the differences between pemphigus and pemphigoid - USMLE Forums
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Old 08-30-2010
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Skin I always forget the differences between pemphigus and pemphigoid

Can any body clear me the differences between Bullous pemphigoid n pemphigus vulgaris. I always understand n learn n I always forget...........................................: confused:
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Old 08-30-2010
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Cool Good question!

I always found this little chart helpful, hope this helps you also, and i'm already taking into account that you sort of know what they are already...

Pemphigus vulgaris Bullous pemphigoid

Age= Middle age, Elderly
Clinical Features = Monomorphic Polymorphic
Blisters= Rupture easily, Flaccid Tense, firm
Content of Blisters= fluid filled often hemorrhagic
Oral Lesions= Common Rare
Nikolsky's sign= Positive Negative
Tzanck smear= Acantholysis No Acantholysis
D. Immunoflourescence= Intraepidermal deposits Deposits at the epidermal basement membrane
zone= Target antigen Desmoglein 1 & 3 BPAG2- -(type 17 collagen)

though for some reason i couldn't get it exactly in a table form, but i color coded it so it'll be easier....also remember that Nikolsky's sign is positive when slight rubbing of the skin results in exfoliation of the skin's outermost layer.

hope this helps
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Old 08-31-2010
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I found this helpful thought i should share.....

Pemphigus vulgaris vs Bullous pemphigoid

PemphiguS = Superficial

PemphigoiD= Deep

PemphiguS = Superficial Separation => Intraepidermal Acantholysis => Flaccid bullae that rupture easily => Infection=> death if not treated.

PemphigoiD= Deep epidermal junction => Tense bullae that don't rupture easily => Heal without scarring
Knowing is not enough; we must apply.
Willing is not enough; we must do.
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Old 09-01-2010
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I always remember it like this to get me started. Like on the test, I'm not going to sway, its going to be clear cut / black and white

pemphigus vulgaris- is vulgar, meaning swears a lot/mouthy. Blisters in the mouth and mucus. Because the blisters go in more places its going to have a more serious effect. then add AB against desmosomes, circular immunoflurescence, in epidermis, oral lesions.

Key to know: AB against Desmosomes, oral lesions in mouth

Bullous pemphigoid- is only on the skin. Ab against hemidesmosomes, linear immunofluoresence, subepidermal, floating keratinocytes

Key to know: AB against hemidesmosomes, no blisters in oral/mucosa

They will ask you a clinical question, something like;

a 4 year old girl started to have blisters on her skin that slough off easy, when you exam her you noticed blisters in the mouth. You run some tests and see there are some circular immunoflurence, what else would you see?

A) AB against desmosomes
B) floating keratinocytes
C) Ab against hemidesmosomes
D) Double Stranded DNA virus
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Old 09-01-2010
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Link Another useful thread

This may also help

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Pathology-, Skin-

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