09-03-2011, 06:22 PM
A 45-year-old man comes to your clinic complaining of skin and mouth lesions. Painful oral ulcers started
to appear in his mouth 1 month ago. Over the past week, he has also noticed some skin lesions on
his upper chest and back. He has no significant medical history and is not taking any medications. His
physical examination is unremarkable except for the presence of several superficial tender ulcers on his
oral mucosa and six superficial coin-sized lesions on his back and chest, which are surrounded by normal
skin. The Nikolsky sign is positive.
On the basis of clinical presentation, which of the following is the most likely diagnosis for this
patient?
❑ A. Bullous pemphigoid
❑ B. Pemphigus vulgaris
❑ C. Pemphigus foliaceus
❑ D. Porphyria cutanea tarda
to appear in his mouth 1 month ago. Over the past week, he has also noticed some skin lesions on
his upper chest and back. He has no significant medical history and is not taking any medications. His
physical examination is unremarkable except for the presence of several superficial tender ulcers on his
oral mucosa and six superficial coin-sized lesions on his back and chest, which are surrounded by normal
skin. The Nikolsky sign is positive.
On the basis of clinical presentation, which of the following is the most likely diagnosis for this
patient?
❑ A. Bullous pemphigoid
❑ B. Pemphigus vulgaris
❑ C. Pemphigus foliaceus
❑ D. Porphyria cutanea tarda