Pemphigus Vulgaris vs Bullous Pemphigoid - Comparison Table
Pemphigus Vulgaris
 • Epidemiology: Average age 40-60
 • Time course: Chronic, relapsing
 • Symptoms: Painful
 • Mucosal involvement: Common
 • Bullae: Flaccid, many already ruptured
 • Nikolsky sign: Positive
 • Antibodies: Autoantibodies against desmoglein 1 and 3
 • Histology: Suprabasilar clefting, "row of tombstone" pattern of basal keratinocytes.
 • Direct Immunofluorescence: Intercellular IgG deposits
 • Treatment: Systemic glucocorticoids + /- nonsteroidal immunomodulator

Bullous Pemphigoid:
 • Epidemiology: Elderly >60
 • Time course: Chronic, relapsing
 • Symptoms: Itchy
 • Mucosal involvement: 10-30%
 • Bullae: Tense
 • Nikolsky sign: Negative
 • Antibodies: Hemidesmosomal bullous pemphigoid antigens BP 230 and BP 180
 • Histology: Subepidermal clefting
 • Direct Immunofluorescence: Linear IgG deposits at basement membrane
 • Treatment: Systemic or topical glucocorticoids + /- nonsteroidal immunomodulator

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