A 45 yr old female developed recurrent oral erosions followed by multiple flaccid bullae on trunk and extremities. A tzanck smear showed acantholytic cells and direct immunofluoroscence showed intercellular IgG deposits in the epidermis. The most probable diagnosis is:
Recurrent, painful oral lesions and cutaneous lesions in the form of flaccid bullae are characteristic of phemphigus vulgaris Positive Tzanck smear, IgG deposits on direct immunofluoroscence positive nikolsky's sign are features of phemphigus vulgaris. Ref: Textbook of Dermatology, Venereology and Leprology By Devinder Mohan Thappa, 2nd Edition, Chapter 12, Pages 152-53; Dermatology (A coloured Hand Textbook) By R. J. G. Rycroft, S. J. Robeson, Sarah H. Wakeli, 2nd Edition, Pa 1, Pages 54, 55
Bullous Pemphigoid
Stevens Johnson syndrome
Herpes simplex 1 infection
Pemphigus vulgaris