View source for Pemphigus vulgaris

== 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

[[Category:Dermatology]]