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Pemphigus Symptoms & Diagnosis


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


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

Skin proceedure
© 2009 Nucleus Medical Art, Inc.

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