Pemphigus vulgaris
From IDWiki
Background
- Blistering skin condition of unknown etiology
- Associated with autoantibodies targeting cadherins
Drug-Induced
- Penicillamine and captopril
- NSAIDs, penicillin, and cephalosporins
- Possibly certain foods, though mostly anecdotal
Clinical Manifestations
- Initially presents in oral mucosa in 80% of cases
- Followed by cutaneous lesions
- Lesions are bullae that rupture leaving painful erosions
- Nikolsky sign may be present, where blisters form at sites of minor pressure or minor trauma
Diagnosis
- Based on clinical, histopathological, and laboratory evidence
- Skin biopsy is helpful
- Direct immunofluorescence can show net-like or chicken-wire pattern of IgG on the epidermis
- Tzanck smear shows acantholysis
Management
- Systemic corticosteroids
- Rituximab and other anti-CD20 monoclonal antibodies
