Pathology · single question

What is the BEST biopsy technique for mucous membrane pemphigoid?

  1. Perilesional biopsy (adjacent to lesion)
  2. Excisional biopsy
  3. Incisional biopsy of the lesion itself
  4. No biopsy needed
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Correct answer: A. Perilesional biopsy (adjacent to lesion)

For vesiculobullous/autoimmune diseases (MMP, pemphigus), a PERILESIONAL biopsy is taken from ADJACENT to the lesion — the lesion itself often ulcerates/necroses, providing poor tissue for diagnosis. The perilesional tissue is intact epithelium where immunofluorescence can show IgG/IgA/C3 deposition along the BMZ. DIF (direct immunofluorescence) is the gold standard.

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