A 60 year's old male patient presented with blisters over trunk and thighs for 2 weeks. Lesions are mildly itchy. On examination blisters were tense with erythematous base. Nikolsky's sign is negative. There was no mucosal involvement.: (A) Pemphigus vulgaris, (B) Pemphigus vegetans, (C) Bullous pemphigoid, (D) Dermatitis herpetiformis
Answer is C. Ans. is 'c' i.e. Bullous pemphigoid Points in favour of bullous pemphigoid* Age group - 60 years* Blisters over trunk and thighs.* Blisters are tense. Base is erythematous* Mild Itching.* Nikolsky's sign is negative* No mucosal involvementAbout other optionsPemphigus vulgaris* Common age group involvement for pemphigus is 20-40 years.* Blisters are flaccid on normal base.* Itching is mild or absent in pemphigus.* Nikolsky's sign is positive.* Mucosal involvement is characteristic feature in pemphigus.Pemphigus vegetans* Blisters and erosions are associated with verrucous vegetations in the intertriginous areas (the axillae, groins and inframammary folds), scalp and the face.Dermatitis herpetiformis* Age group - DH is commonly seen in 2nd to 3rd decade* Itching is very prominent (characteristic feature)* Lesions are symmetrically distributed over extensor surfaces (elbow, knees, buttocks, back, scalp, posterior neck.* Lesion is usually polymorphic and occurs in crops.