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Table 1 Salient features to differentiate between pemphigus vulgaris and paraneoplastic pemphigus

From: Pemphigus vulgaris as the first manifestation of multiple myeloma: a case report

  Pemphigus vulgaris Pemphigus paraneoplastic
Clinical findings • Oral erosions particularly on the labial and buccal mucosa • Painful, progressive stomatitis involving the tongue
• Blisters and targetoid lesions on the palms and soles
Direct immunofluorescence • Intercellular deposition of IgG and C3 in “chicken-wire” lattice pattern • IgG deposition in all layers of the epidermidis and C3 in the lower epidermis and basement membrane
• Intercellular staining is focal and faint
Autoantibodies • Autoantibodies against desmoglein-1 and desmoglein-3 • Autoantibodies against desmoglein-1 and desmoglein-3
• Autoantibodies against proteins in the plakin family (plectin, desmoplakin I, desmoplakin II, bullous pemphigoid antigen I, envoplakin, and periplakin)
Visceral involvement • Very rare • Mucous membranes of the esophagus, stomach, duodenum, intestines, and pulmonary epithelium
  1. IgG immunoglobulin G