A previously healthy 44-year-old woman presented to the oral medicine clinic with an 11-month history of mouth ulcers and blistered lips. The lesions had caused pain while eating, with resultant unintentional weight loss. She also reported a 6-month history of skin blisters on her arms and legs. On physical examination, the lips were swollen with bleeding erosions and yellow pustules. Erosions were seen on the hard palate, as well as on the floor of the mouth, tongue, and buccal mucosa. Gingivitis and halitosis were also present. Flaccid bullae and blisters were seen on the skin of the arms and legs. Biopsy of the gingiva revealed intraepithelial separation and retention of basal cells along the basement membrane. Direct immunofluorescence of the biopsy specimen showed IgG deposition along epithelial-cell membranes, resulting in a “chicken wire” pattern. What is the most likely diagnosis?
一位既往健康的44岁女性因口腔溃疡和唇部水疱11个月就诊于口腔医学诊所。这些病变导致进食疼痛，并导致非故意的体重减轻。她还报告了6个月的手臂和腿部皮肤水疱病史。体检发现唇部肿胀，伴有出血性糜烂和黄色脓疱。硬腭、口腔底、舌部和颊黏膜可见糜烂。还存在牙龈炎和口臭。手臂和腿部的皮肤上有松弛性大疱和水疱。牙龈活检显示表皮内分离，基底细胞沿基底膜保留。直接免疫荧光显示IgG沿上皮细胞膜沉积，呈“鸡网”样模式。最可能的诊断是：
A. Behcet’s disease白塞病
B. Bullous pemphigoid大疱性类天疱疮
C. Linear IgA bullous dermatosis线状IgA大疱性皮肤病
D. Pemphigus foliaceus落叶型天疱疮
E. Pemphigus vulgaris寻常型天疱疮
答案解析：
寻常型天疱疮是一种自身免疫性黏膜皮肤大疱性疾病。几乎所有寻常型天疱疮患者都会出现黏膜受累，大约一半患者的口腔病变先于皮肤病变出现。
正确答案：E
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