Pemphigus Vulgaris

Q. I have blisters over my chest area. How do I know if it’s Pemphigus vulgaris?

A. There are many conditions that may give you blisters over the chest area. An exact diagnosis requires investigations. You need to visit a dermatologist’s clinic for this. He may examine you and then take out Punch Biopsy from underneath the blister. This tissue sample would then be examined under the microscope to make a diagnosis.

Q. Can symptoms alone not diagnose the condition?

A. Symptoms are suggestive of the condition. However, exact diagnosis requires direct skin biopsy.

Q. What symptoms suggest that blisters over the chest may be Pemphigus vulgaris?

• Typical symptoms are blisters over the skin of chest area and inside the mouth cavity. Not uncommonly, the genital area, eyes, nose or throat may also be affected.
• Blisters do not itch. However, they may be painful, particularly the ones over the mucous membranes of the mouth, throat or genitals.
• Patient may also present with oozing ulcers, which happen when the blisters become infected.
• Patients may have difficulty swallowing food.

Q. What other conditions look like pemphigus vulgaris?

A. Blisters may flare up and look like warts. The condition may mimic Herpes. Smaller blisters may initially look like an allergy, until yup notice them in the throat too.

Q. Is the disease contagious?

A. No. Though the blisters that erupt over skin surface are filled with pus like material, the disease is not contagious. This is an autoimmune disorder.

However, if the blisters get infected from outside, this secondary infection is contagious. So, it’s not advisable to touch the blister or pus with naked hands.

Q. What is Pemphigus vulgaris?

A. This is an autoimmune disease. The mechanism, as understood till date, is that our immune system turns against our own skin cells, targeting a certain location over the body.

In a normal body, immune cells are produced by the bone marrow to combat against bacteria, viruses and other invading foreign agents. Sometimes, these immune soldiers wrongly start targeting body’s own cells as enemies and cause them damage.

There are many different kinds of autoimmune disease, depending upon what cells of the body are targeted by our own immune cells.

Q. Who is likely to get Pemphigus Vulgaris?

A. Anyone can get the condition. However, we see it more commonly in middle aged men of Jewish descent, south east Asian origin or people from southern Europe.

Q. How is Pemphigus vulgaris treated?

A. Mainstay of treatment is suppressing the immune system to prevent damage to body cells. Corticosteroids are the first line of medicines given. If not effective, stronger immunosupressants like, azathioprine, methotrexate may be used.

The infected blisters are treated with proper antibiotics. Bland, non irritating diet is given to prevent ulcerations in the mouth cavity and throat.

Patient is advised to eat healthy and avoid too much of sweating or worrying.

In some cases, hospitalization may be needed.

Q. How long does it take to get completely treated?

A. Treatment may have to be continued all life in most cases. Though there are phases of exacerbation of the disease, when higher doses of medications may be needed.

A well managed life needs to be planned to long term prognosis.

Q. Are there any side effects of the medications given?

A. Yes. Long term use of steroids may lead to high blood sugars. Patient may become prone to cancers and other secondary infections. Thinning of skin may occur, if applied topically.