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Pemphigus Vulgaris – Pictures, Symptoms, Causes and Treatment

Written by Dr.Mary

What is Pemphigus Vulgaris?

Pemphigus is a collection of skin disorders which are very rare and which cause the skin or mucous membranes to blisters – such as on the genitals or mouth.

These conditions can develop at any age but most often occur in individuals in middle age or older. The form of pemphigus which is most common is pemphigus vulgaris which leans towards involvement in those individuals of Jewish or Middle Eastern descent – but it can actually affect people from all races.

Pemphigus is normally a condition which is chronic and is controlled best when diagnosis and treatment is early. Treatment includes drug therapy or therapy which is similar to those used for burns which are severe. Pemphigus is easier to control the less widespread it is.

Pemphigus Vulgaris Symptoms

This condition is notable by blisters which develop on skin as well as mucous membranes. These blisters easily rupture which leaves sores which are open, can ooze and become infected.

The symptoms and signs of pemphigus vulgaris include:

  • Initially develops as blisters in the mouth
  • They erupt on the skin
  • Blisters also break out on mucous membranes of the genitals
  • Blisters are painful
  • Blisters do not itch
  • Blisters in mouth or throat can make it difficult to eat or swallow

An individual should see their primary care physician if they develop any blisters on the skin or inside the mouth. If there has already been a diagnosis of pemphigus and are already being treated, see your physician if any of the following develop:

  • New sores or blisters
  • Number of sores spread rapidly
  • Chills
  • Fever
  • Achy joint or muscles

Pemphigus Vulgaris Causes

Just exactly what causes pemphigus is not known but it is believed to be an autoimmune disorder.

Usually when the body is functioning normally, the systems of immunity will attacks any foreign bodies or invaders for instances bacteria or viruses. With pemphigus, the immunity system produces antibodies which attack cells on the skin or mucous membranes which are healthy. In the majority of the cases, the antibodies will attack proteins known as desmogleins which binds skin cells together. These antibodies binding to the skin will cause the separation of the cells from the top layer of your skin which is known as the epidermis. This separation reaction is called acantholysis.

Often, pemphigus grows as a side effect of certain drugs for example blood pressure medication, or chelating agents. The type of permphigus normally goes away when the drug or medication is stopped.



Possible complications of this condition include:

  • Skin infections
  • Sepsis which is an infection which spreads thru the blood system
  • Side effects from drugs such as an increased infection risk
  • Death from infection which is extremely rare

Pemphigus Vulgaris Treatment

Most treatments have a goal of reducing the symptoms and signs and also to prevent any complications. Treatment is most effective when it starts as early as possible. The less widespread this condition is, the simpler it can be to manage or control. The treatments which are specific depend on the severity of this condition.

Mild pemphigus

When it is not too widespread, treatment may be able to be done at home. Drugs can be used alone or in some combination with others to treat this condition.

  • Corticosteroids –  The main treatment is normally with corticosteroids like prednisone. But using corticosteroids for a long period of time or in very high doses can cause many serious side effects, which can include bone loss, increased risk of infection, water retention, increased blood sugar, cataracts, glaucoma as well as a relocation of body fat, which leads to a face which is round and normally referred to as a moon face.
  • Immunosuppressants – These are drugs such as azathioprine, methotrexates or mycophenolate which can help to keep the immune system from attacking the healthy tissues. But these medications can have very serious side effects including an enlarged risk of infection.
  • Antivirals, antifungal medications as well as antibiotics – These can be prescribed to prevent or control infections, usually infections from staphylococcus bacteria or herpes viruses.

Severe pemphigus

Pemphigus which is widespread can mean a stay in the hospital where treatment similar to severe burn treatment can be applied. The sores which are open make the individual at high risk of infection, which if spreads to blood system can be deadly. As well as medications listed above, the following can be used:

  • Fluids – Because of the loss of fluids due to oozing of these sores, the individual can receive fluids thru an IV set up, as well as electrolytes such as potassium, calcium as well as sodium and also proteins.
  • Feeding intravenous – This can become necessary because of mouth sores
  • Anesthetic mouth lozenges – These control the pain of mild to moderate mouth sores.
  • Therapeutic plasmapheresis – With this process, the fluid called plasma is removed from other parts of the blood by a device which is called a cell separator. The reason for this is to rid the plasma of any antibodies which are attacking the skin. This plasma is replaced with plasma which is donated or intravenous fluids.

For many individuals, the treatment will cause all of the blisters or sores to leave completely in a few months and then treatment may be discontinued. But others have to remain on a low dose of drugs for an indefinite period or the symptoms and signs can return.

Home Therapy

There are many steps which you can take to help improve the skin and overall health:

  • Take caution to avoid any trauma to the skin.
  • Get wound care instruction from your doctor. This can help infection as well as scarring.
  • Use talcum powder on sheets to keep oozing skin from sticking
  • Avoid acidic or spicy foods as well as garlic, onions or leeks as this may trigger or irritate blisters
  • Use dressings or lotions. Treat blisters or sores with drying or soothing lotions or wet dressings.
  • Minimize exposure to the sun which could trigger new blisters.
  • If you have blisters in the mouth, talk with your dentist about maintaining proper as well as good oral health.

Discuss with your doctor about taking vitamin D as well as calcium supplements. Taking corticosteroids depletes these substances.

Pemphigus Vulgaris Pictures

  1. Excellent, keep up doing the great work , very valuable information i liked it a lot.

  2. A clear and simple explanation on the autoimmune. I am currently being treated with Azathioprine, dapsone and prednisolone.

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