You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 24 years old female has flaccid bullae in the skin and oral erosions. Histopathology shows intraepidermal acantholytic blister. The most likely diagnosis is : and explain in detail?
Ans. is 'c' i.e. pemphigus vulgaris Bullae involving oral mucosa with intraepidermal lesions & acantholysis is characteristic of pemphigus.Here is a D/d of commonly asked vesico bullous disordersVesiculobullous disordersINFECTIOUSHerpes SimplexCluster of vesicles usually on face*Painful*Recurrent*Two types-Type I -Seen in childhood gingivostomatitis*, fever, vesicle's on lipsType II -In young adults after sexual contact usually involves genitaliaHerpes ZosterVesicular eruption occurs in dermatomal pattern*. Thoracic dermatome is the most commonly involved (50%)*Involvement of ophthalmic division of trigeminal N.*Painful and tender*2/3 of patients over 40 yrs of ageNON-INFECTIOUS PemphigusVesicles are seen on the upper part of body. Trunk > limbs.Lesions are non itchy and painless*Oral mucosa involvement* in 50% cases.Lesions are intraepidermal*Acantholysis present*Nikolsky sign present*Age Group 40-50 Pemphigoid 1. Vesicles seen on the lower part of body, limbs >trunk.*2; Lesions are non itchy and painless*Oral mucosa not involved*Lesions are subepidermal*Acantholysis absent*Nicolasky sign absent*Age Group 60-80 Dermatitis HerpetiformisVesicles seen on extensor surface*Vesicles are itchy and painless*Villous atrophy usual*Lesions are subepidermal*Young adults are involved Erythema multiformeCharacteristic vesicular lesions on hands and feet (target lesion)*non itchy and painless.face and upper limbs involvedmucosal involvement can be seen So the crux is* Painful lesions are seen in-. Herpes infection.* Painless lesions are seen in-Dermatitis herpetiformis Pemphigoid Pemphigus Erythema multiforme* Dermatomal involvement-. Herpes zoster* Itchy lesions-Dermatitis herpetiformis* Intraepidermal-. Herpes and pemphigus* Subepidermal-. Dermatitis herpetiformisPemphigoid Erythema multiforme