Tomb Stone Appearance


Tomb Stone Appearance is Classically described in the histopathology of


A. Bullous pemphigoid

B. Pemphigus vulgaris

C. Rhinophyma

D. Dermatitis herpetiformis




Tombstone sign – Pemphigus vulgaris:


  1. Suprabasal acantholysis
  2. Basal layer remains attached (tombstone sign)

Most common form of pemphigus


A. Pemphigus vulgaris

B. IgA pemphigus

C. Pemphigus foliaceus

D. Paraneoplastic pemphigus



Most common form of pemphigus


A. Pemphigus vulgaris

B. IgA pemphigus

C. Pemphigus foliaceus

D. Paraneoplastic pemphigus



Pemphigus vulgaris most commonly presents with


A. Anus

B. Cutaneous blisters

C. Conjunctiva

D. Oral blisters



Pemphigus vulgaris is classified as

A. Type I hypersensitivity reaction

B. Type II hypersensitivity reaction

C. Type III hypersensitivity reaction

D. Type IV hypersensitivity reaction



In Pemphigus vulgaris antibodies are formed against


A. Connexins 

B. Desmosomes

C. Gap Junctions

D. Actin filaments



Which Mutations are the main cause of arrhythmogenic cardiomyopathy


A. Connexins 

B. Desmosomes

C. Gap Junctions

D. Actin filaments



Which sign is positive in Pemphigus vulgaris


A. Abadie’s sign

B. Nikolsky sign

C. Bancroft’s sign

D. Battle’s sign



Which is the is the dominant autoantibody subclass in PV and correlates with disease activity

A. IgA

B. IgM

C. IgE

D. IgG



Which is the is the dominant autoantibody subclass in PV and correlates with disease activity


A. IgG1

B. IgG2

C. IgG3

D. IgG4



Row of the tomb stone


Classically described in the histopathology of fresh blister of pemphigus vulgaris or drug-induced pemphigus.

Suprabasal splitting of the epidermis leads to blister formation,

With the basal layer still remaining adherent to the basement membrane – This gives the resemblance to the ‘Row of the tomb stone’.


Pathophysiology


Classified as a type II hypersensitivity reaction in which antibodies are formed against desmosomes


Pathophysiology


IgG or IgA autoantibody against epidermal antigens


Pemphigus vulgaris Pathophysiology


Pemphigus vulgaris: IgG to desmoglein 1 (skin) or desmoglein 3 (mucosa)


Pathophysiology


Pemphigus foliaceus – Pemphigus foliaceus: IgG to desmoglein 1

Paraneoplastic pemphigus: IgG to desmoplakin I, desmoplakin II, plectin, periplakin, envoplakin, BP230 or A2ML1


IgA pemphigus Pathophysiology


IgA to desmocollin 1- subcorneal pustular dermatosis [SPD] variant)

IgA to desmoglein 1, desmoglein 3 – intraepidermal neutrophilic [IEN] variant


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