The immune system produces antibodies against specific proteins in the skin and mucous membranes. These antibodies break the bonds between skin cells. This leads to the formation of a blister. The exact cause is unknown.
In rare cases, pemphigus is caused by some medicines, including:
Pemphigus is uncommon. It most often occurs in middle-aged or older people.
About 50% of people with this condition first develop painful blisters and sores in the mouth. This is followed by skin blisters. Skin sores may come and go.
The skin sores may be described as:
They may be located:
Severe cases of pemphigus may need wound management, similar to the treatment for severe burns. People with PV may need to stay in a hospital and receive care in a burn unit or intensive care unit.
Treatment is aimed at reducing symptoms, including pain. It also aims to prevent complications, especially infections.
Treatment may involve:
Body-wide (systemic) therapy is needed to control pemphigus and should be started as early as possible. Systemic treatment includes:
Antibiotics may be used to treat or prevent infection. Intravenous immunoglobulin (IVIg) is occasionally used.
Plasmapheresis may be used along with systemic medicines to reduce the amount of antibodies in the blood. Plasmapheresis is a process in which antibody-containing plasma is removed from the blood and replaced with intravenous fluids or donated plasma.
Ulcer and blister treatments include soothing or drying lotions, wet dressings, or similar measures.
Without treatment, this condition can be life threatening. Severe infection is the most frequent cause of death.
With treatment, the disorder tends to be chronic. Side effects of treatment may be severe or disabling.
Complications of PV include:
Ferri FF. Pemphigus vulgaris. In: Ferri FF, ed. Ferri's Clinical Advisor 2016. Philadelphia, PA: Elsevier; 2016:941-942.
Habif TP. Vesicular and bullous diseases. In: Habif TP, ed. Clinical Dermatology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 16.
James WD, Berger TD, Elston DM. Chronic blistering dermatoses. In: James WD, Berger TG, Elston DM, eds. Andrew's Diseases of the Skin. 12th ed. Philadelphia, PA: Elsevier; 2016:chap 21.
Last reviewed on: 4/29/2016
Reviewed by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.