A 54-year-old woman presents with a 2-month history of recurrent, painful erosions of the oral mucosa and a 1-week history of flaccid blisters on the flexural surfaces of her trunk. Physical examination reveals multiple ruptured blisters with thin, friable roofs in the axillae and groin, along with erosions on the buccal mucosa and soft palate. A positive Nikolsky sign is noted on the skin. Histopathologic examination of a perilesional skin biopsy demonstrates acantholysis with intraepidermal blister formation at the level of the stratum spinosum, with preservation of the basal keratinocytes. Immunofluorescence microscopy reveals intercellular IgG deposits in the epidermis. Which of the following cell junction components is the primary target of the autoimmune response in this patient?
- A)Gap junctions (connexons)
- B)Tight junctions (claudins and occludin)
- C)Hemidesmosomes (α6β4 integrin and BP180)
- D)Adherens junctions (cadherins and catenins)
- E)Desmosomes (desmogleins and desmocollins)GABARITO
Explicação
This patient has pemphigus vulgaris, characterized by autoimmune attack on desmosomes. The IgG autoantibodies target desmogleins (primarily desmoglein 3, and sometimes desmoglein 1), which are calcium-dependent adhesion molecules that form the core of desmosom... Ver explicação completa e trilha adaptativa →