Dermatology >>>> Pemphigus

Pemphigus.

Pemphigus is a disease from the group of bullous dematosis of autoimmune origin. The reasons for the development of pemphigus have not yet been clarified, but there is evidence that IgG antibodies play a special role in autoimmune processes during the development of pemphigus, which oppose the antigens of the extracellular fluid of stratified squamous epithelium (intercellular substance of the spiny layer of the epidermis). During immunological studies, an increased content of the IgG group immunoglobulin is found in the blood serum , which activates the complement system, as a result of which complexes are formed that violate the permeability of keratinocyte membranes.

Pemphigus is a chronic disease with periodic relapses, it is characterized by an undulating course.

The clinical signs of pemphigus appear as four forms of the disease:

Pemphigus vulgaris or vulgaris,
Vegetative pemphigus,
Pemphigus foliaceus,
Seborrheic or erythematous pemphigus.

With the exception of pemphigus foliaceus, all its other forms appear not only on the skin, but also on the mucous membrane (oral cavity, intestines, vagina). Externally, pemphigus looks like blisters (or watery plaques) of various sizes, scattered over the surface of non-inflamed skin and mucous membranes. Gradually, the bubbles spread over the entire surface of the skin of the body. Over time, the blisters can burst and leave behind only a dark spot on the skin, without scarring, which distinguishes pemphigus from some blister dermatoses.

Due to the fact that the external manifestations of pemphigus are typical, the disease is quite easy to diagnose, but it should be differentiated from other cystic diseases (bullous pemphigoid, Duhring disease, exudative erythema multiforme, discoid lupus erythematosus, Lyell syndrome, and others). The diagnosis is confirmed by laboratory tests: histological, cytological, immunomorphological.

Treatment of pemphigus is aimed at suppressing the inflammatory reaction, reducing the rate and suppressing new rashes, epithelialization of erosive tissue foci, and increasing the duration of remission.

Treatment is carried out with glucocorticosteroid drugs of systemic action, which are prescribed for health reasons. The dose of the drug is selected by the doctor, correlating it with the severity of the disease and the prevalence of rashes.

To increase the effectiveness and reduce the dose of glucocorticosteroids, cytostatics are used.

Along with the aforementioned drugs, immunosuppressive therapy can be carried out, but today its use is not generally recognized.

During the period of treatment, the patient is recommended to lead a lifestyle not overloaded with emotional and physical stress.

The diet should include foods rich in proteins, trace elements, vitamins. It is necessary to exclude coarse fiber foods, salty, sour, smoked, fried foods from the diet so as not to injure the damaged mucous membranes of the digestive tract.

The prognosis of the disease depends on the prevalence of the process: with a rapid increase in the number of bubbles, rapid decay of the contents of the bubbles, emerging complications and a worsening of the general condition of the patient, the prognosis is poor (death). Solitary blisters that occur with a long interval of time, treated in a timely manner, do not pose a danger to the patient.