Symptoms
Itching and pain are common symptoms. Pemphigus may occur over a small or large section of the skin. Symptoms differ among the types.
Pemphigus Vulgaris
- Blisters usually start in the mouth or on the scalp
- Lesions progress to the face, neck, upper body, armpits, and groin
- Blisters also may occur in the esophagus, rectum, nose, throat, larynx (voice box), eyes, vulva, or rectum
- Surrounding skin may be red or normal color
- Pressure on the blister may cause it to expand into surrounding tissue
- Outer layer of skin can easily be rubbed off
- Blisters are soft and break easily, releasing fluid
- Open sores are painful
- Large areas of skin may open up, increasing the risk of fluid imbalance and infection
- Blisters usually heal without scarring, but skin color may change to brown
Pemphigus Foliaceus
- Blisters are itchy or produce a burning sensation
- Sores are usually not found in the mouth or on other mucus membranes
- Blisters usually first show up on the face, scalp, chest, or upper back
- Blisters open, causing shallow sores
- Skin is red
- Scales and crusts form
- Sunlight may make symptoms worse
Paraneoplastic Pemphigus
- Sores occur on the mucous membranes, in the mouth, eye, and esophagus
- Blisters often appear on palms of hands and soles of feet
- Lesions are itchy or painful
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done. This will include a thorough skin exam. Special care is given to examining the lesions.
Tests may include:
- Skin biopsies of the lesion and surrounding tissue
- Skin test to determine the level of antibodies by immunofluorescence
- Blood test to check the level of antibodies by immunofluorescence
Skin Biopsy
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