Pemphigus

1 What is Pemphigus?

A group of rare skin disorders that can cause sores and blisters on the skin or mucous membranes in the genitals or mouth is called pemphigus.

The two main types are Vulgaris that starts in the mouth and can be painful and Foliaceus that affects the skin and cab be itchy.

This disease often occurs at middle-aged people but can occur at any age.

Pemphigus is not the same as bullous pemphigoid. Medications and therapies are the treatments for this disease.

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2 Symptoms

Symptoms of pemphigus vary depending on its type.

Blisters that rupture easily, leaving open sores that may ooze and become infected on your skin and mucous membranes are the characterization of pemphigus.

The symptoms of this include:

  • Pemphigus vulgaris - You will have a blister that are painful but not itchy on your mouth and then on your genital mucous membranes or skin. You may have a hard time swallowing and chewing
  • Pemphigus foliaceus - This can affect the skin and not painful but are itchy and crusty, and usually on the back, shoulders and chest.

Consult your doctor if you notice that you have any blisters in your skin or mouth to receive treatment.

Consult your doctor if

  • a rapid spread in the number of sore;
  • new blisters or sores;
  • chills,
  • weakness or achy joints or muscles;
  • and fever or redness and swelling that may indicate infection.

3 Causes

In most cases, it's unknown what causes pemphigus.

Pemphigus is an autoimmune disorder which means that your immune system will produce antibodies that can attack healthy cells in your mucous membranes and skin and is not contagious.

This disease usually develops as a side effect of medication but is rarely.

4 Making a Diagnosis

It can be difficult to diagnose pemphigus because it occurs with a number of conditions.

Your doctor will likely examine your mouth and skin and may recommend

  • biopsy – a sample of your tissue from the blister will be examined under a microscope;
  • check for skin peeling – the top layers of your skin will shear off when your doctor rubs a patch of normal skin near the blistered area with a swab;
  • blood tests – to identify and detect the antibodies in your blood (desmogleins);
  • endoscopy exam – to look for sores in the throat that will use endoscope down your throat.

5 Treatment

Medications can be used to relieve of the symptoms and to prevent future complications because if not treated early can be fatal.

Some medications include:

  • Corticosteroids: for the mild disease such as prednisone pills but have serious side effects of corticosteroids if high in dosages such as bone loss, increased blood sugar, cataracts, increased in the risk of infection, moon face and glaucoma,
  • Immunosuppresants: Azathioprine (Imuran) or Mycophenolate mofetil (CellCept) so your immune system will not attack healthy tissues,
  • Antibiotics, antiviral and antifungal medications: to prevent infections,
  • Biological therapies: rituximab (Rituxan) as an injection that will target the white blood cells responsible for producing pemphigus antibodies,
  • Other medications: Dapsone and intravenous immunoglobulin.

In some cases you need to stay in the hospital and in there you may be given:

  • Fluids: you may receive fluids through a vein (intravenously) because of loss of fluid in your body,
  • Intravenous feeding: if you have a mouth sore. This is done by putting a tube through your nose and into your stomach (nasogastric tube),
  • Anesthetic products for your mouth: to control pain in mouth sores,
  • Therapeutic plasmapheresis: to get rid of antibodies which are attacking your skin,
  • Wound care: baths and dressings so that your blisters will heal.

6 Prevention

There is no way of preventing pemphigus but managing the symptoms can be helpful such as:

  • if you have blisters in your mouth,
  • have a soft diet,
  • eat foods that are not hard to chew,
  • use soft toothbrush to minimize local trauma in your mouth (you can ask your dentist what type of toothbrush you can use),
  • minimize sun exposure,
  • use protective clothing to protect your skin.

7 Alternative and Homeopathic Remedies

There are no homeopathic remedies for pemphigus.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with pemphigus. These include:

  • take good care of your wound to avoid future infection;
  • put talcum powder on your sheets to relive the itch;
  • continue your medications;
  • avoid activities that may contaminate your wounds leading to infection like playing contact sports;
  • always use clean towels and clothing to avoid infection in the wounds;
  • minimize sun exposure for ultraviolet may trigger new blisters;
  • avoid some foods such as garlic or onion so your mouth will not be irritated;
  • consult your doctor if you need to take extra vitamin D and calcium;
  • and ask your dentist ways on how to protect your oral health.
  • look for a support group in your area to help you cope with this disease.

9 Risks and Complications

You are at risk of pemphigus if you are middle-aged or older or pemphigus vulgaris if you are from a Jewish descent.

Open sores can cause infections that can sometimes be fatal if it spreads in your bloodstream and it includes:

  • Sepsis, an infection that spreads in your bloodstream;
  • infection of skin;
  • medication side effects like high blood pressure;
  • tooth loss and gum diseases;
  • and death from infection.

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