A patient presented with multiple vesicles over the body with fish net like IgG deposition in the epidermis. Most likely diagnosis is –
**Core Concept**
Pemphigus vulgaris is a chronic autoimmune skin disease characterized by the formation of blisters (bullae) on the skin and mucous membranes. It is caused by autoantibodies against desmoglein 3 proteins, which are components of the desmosomes that hold skin cells together.
**Why the Correct Answer is Right**
The patient's presentation of multiple vesicles over the body with fish net-like IgG deposition in the epidermis is consistent with pemphigus vulgaris. This is because the autoantibodies in pemphigus vulgaris target the desmoglein 3 proteins, leading to the breakdown of the desmosomes and the formation of blisters. The fish net-like IgG deposition is a characteristic feature of this disease, as the autoantibodies deposit in a linear pattern along the basement membrane zone.
**Why Each Wrong Option is Incorrect**
**Option A:** Dermatitis herpetiformis is a different autoimmune skin disease characterized by blisters filled with a watery fluid, but it is not associated with IgG deposition in the epidermis.
**Option B:** Pemphigus foliaceus is a variant of pemphigus vulgaris that primarily affects the skin, but it is not associated with the same level of IgG deposition in the epidermis as pemphigus vulgaris.
**Option C:** Dermatitis herpetiformis is a different autoimmune skin disease characterized by blisters filled with a watery fluid, but it is not associated with IgG deposition in the epidermis.
**Option D:** Bullous pemphigoid is another autoimmune skin disease characterized by blisters, but it is not associated with the same level of IgG deposition in the epidermis as pemphigus vulgaris.
**Clinical Pearl / High-Yield Fact**
The presence of fish net-like IgG deposition in the epidermis is a characteristic feature of pemphigus vulgaris, and it is essential to consider this disease in the differential diagnosis of patients presenting with multiple vesicles over the body.
✓ Correct Answer: A. Pemphigus vulgaris