Pemphigus: what it is, main types, causes and treatment

Pemphigus is a rare immune disease characterized by the formation of soft blisters, which burst easily and do not heal. Usually, these bubbles appear on the skin, but they can also affect the mucous membranes, such as the lining of the mouth, eyes, nose, throat and intimate area.

Depending on the type and pattern of onset of symptoms, pemphigus can be divided into several types, which include:

• Pemphigus vulgaris: it is the most common type, in which bubbles appear on the skin and in the mouth. The blisters cause pain and can disappear, but usually there are dark spots that last for several months;
• Bullous pemphigus: rigid and deep bubbles appear that do not burst easily, and are more frequent in the elderly. Learn more about this type of pemphigus;
• Vegetative pemphigus: it is a benign form of pemphigus vulgaris, characterized by blisters in the groin, armpits or intimate region;
• Pemphigus foliaceus: it is the most common type in tropical areas, characterized by the appearance of sores or blisters, which are not painful, which appear first on the face and scalp, but which can extend to the chest and other places;

• Pemphigus erythematosus: it is a benign form of pemphigus foliaceus, which is characterized by superficial blisters on the scalp and face, which can be confused with seborrheic dermatitis or lupus erythematosus;

• Paraneoplastic pemphigus: it is the rarest type, as it is associated with some types of cancer such as lymphomas or leukemias.

Although it is more common in adults and the elderly, pemphigus can appear at any age. This disease is not contagious and has a cure, but its treatment, made with corticosteroid and immunosuppressive drugs, prescribed by the dermatologist, can last for a few months or years to ensure the disease is controlled.

Pemphigus vulgaris on the skin

Pemphigus vulgaris in the mouth

What can cause pemphigus

Pemphigus is caused by a change in the person's own immune system, which causes the body to produce antibodies that attack healthy cells in the skin and mucous membranes. Although factors that lead to this change are not known, it is known that the use of some medicines for high blood pressure can cause symptoms to appear, which disappear when the medication is finished.

Thus, pemphigus is not contagious, as it is not caused by any virus or bacteria. However, if the blister wounds become infected, it is possible to transmit these bacteria to another person who comes into direct contact with the wounds, which can lead to the appearance of skin irritation.

How the treatment is done

Treatment for pemphigus is usually done using medications prescribed by the dermatologist, such as:

• Corticosteroids, such as Prednisone or Hydrocortisone: are used in the mildest cases of pemphigus to relieve symptoms. These drugs should not be used for more than 1 week in a row;
• Immunosuppressants, such as Azathioprine or Mycophenolate: decrease the action of the immune system, preventing it from attacking healthy cells. However, by reducing the function of the immune system, there is a greater chance of infection and, therefore, these drugs are used in the most severe cases;
• Antibiotics, antifungals or antivirals: they are used when some type of infection appears in the wounds left by the blisters.

The treatment is done at home and can last for a few months or years, depending on the patient's body and the type and severity of the pemphigus, and during treatment, regular consultations with the dermatologist should be made to make sure that the disease is being controlled.

In the most severe cases, in which severe infections of the wounds appear, for example, it may be necessary to stay in the hospital for a few days or weeks, to make medications directly in the vein and to make appropriate treatment of the infected wounds.

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