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Pathology · single question

When biopsying a suspected case of pemphigus vulgaris, where should the biopsy specimen be taken from?

  1. Perilesional tissue
  2. Directly from the center of an established ulcer
  3. Only from keratinized gingiva, regardless of lesion location
  4. From the contralateral, unaffected side only
Show answer and explanation

Correct answer: A. Perilesional tissue

Biopsying perilesional tissue (just adjacent to active erosions/bullae) captures intact epithelium showing the characteristic intraepithelial, suprabasal split with acantholysis (Tzanck cells) diagnostic of pemphigus vulgaris. A biopsy taken directly from an established ulcer often shows only nonspecific ulceration and inflammation, missing the diagnostic epithelial changes.

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