Pemphigus

Diagnosis

Diagnosis of pemphigus begins with a healthcare professional reviewing your medical history and symptoms, followed by a physical examination of the affected area. Additional tests may include:

• Biopsy. A small sample of blister tissue is taken and examined in a lab to confirm pemphigus.
• Blood tests. These tests detect specific antibodies in the blood that are associated with pemphigus.

Your healthcare professional may refer you to a dermatologist, a specialist in skin conditions, for further evaluation and management.

Treatment

Treatment for pemphigus focuses on controlling symptoms, preventing new blisters, and reducing immune system activity. The approach depends on the type and severity of the disease and any other medical conditions.

Medicines
• Corticosteroids. Mild cases may be treated with topical creams or injections, while more severe cases often require oral corticosteroids such as prednisone. Long-term or high-dose use can cause side effects, including diabetes, bone loss, infections, stomach ulcers, and changes in body fat distribution. Steroids are often combined with other immune-targeting medicines to reduce side effects.
• Immune-targeting medicines. Drugs like azathioprine, mycophenolate, and cyclophosphamide help suppress the immune system to prevent it from attacking healthy tissue. These can increase the risk of infections.
• Other medicines. If first-line treatments are insufficient, options may include dapsone, intravenous immunoglobulin, or rituximab. Antibiotics may be needed to treat secondary infections.

Some patients may require hospitalization for fluids, nutrition, or intensive care.

Most people with pemphigus improve with early and consistent treatment, although recovery may take years and long-term medication may be necessary to control the disease.