Repeated USMLE Questions Step 2 CK- 429

A 72-year-old man complains of itchy skin lesions in the axilla, groin and medial aspect of the thigh. Examination reveals pruritic lesions and bullae in the areas mentioned above and also on forearms and lower legs. There are also painful oral lesions. There is no eye involvement and Nikolsky sign is negative.

What is the most likely diagnosis?

A-Pemphigus vulgaris

B-Bullous pemphigoid

C-Cicatricial pemphigoid


E-Dermatitis herpetiformis


This lesion is most likely bullous pemphigoid. Painful oral lesions and negative Nikolsky sign besides the sites of the lesions confirm the diagnosis. This lesion is similar to pemphigus vulgaris except that Nikolsky’s sign is positive in the later. Cicatricial pemphigoid is a rare blistering disease characterized by scarring of the erosions of the mucous membranes. Scabies and dermatitis herpetiformis have clinical pictures different from this condition.

The correct answer is B

1 thought on “Repeated USMLE Questions Step 2 CK- 429”

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