Pathology · single question
A patient with pemphigus vulgaris and desquamative gingivitis. What type of biopsy should be performed?
Show answer and explanation
Correct answer: A. Perilesional biopsy
- A. Correct. For immunobullous diseases like pemphigus vulgaris, a perilesional biopsy (adjacent normal-appearing tissue) is required for direct immunofluorescence (DIF), showing IgG at intercellular spaces. The lesion center yields only necrotic, non-diagnostic tissue.
- B. Incorrect. Biopsying the lesion center gives necrosis/ulceration — non-diagnostic for immunofluorescence.
- C. Incorrect. Excisional biopsy is for small discrete lesions, not widespread bullous disease.
- D. Incorrect. FNA is for salivary gland masses/lymph nodes, not mucosal lesions.