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Pemphigus
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Skin Hair Nails

Pemphigus

Pemphigus is an autoimmune disorder where the immune system attacks healthy cells in the skin and mouth, resulting in blisters and sores.

Overview

Pemphigus is an autoimmune disorder. If you have it, your immune system attacks healthy cells in your skin and mouth, causing blisters and sores. No one knows the cause. Pemphigus does not spread from person to person and does not appear to be inherited, though some people's genes may put them more at risk.

Pemphigoid

Pemphigoid is also an autoimmune skin disease. It leads to deep blisters that do not break easily. Pemphigoid is most common in older adults and may be fatal for older, sick patients.

Diagnosis and Treatment

Doctors diagnose pemphigus with a physical exam, a biopsy, and blood tests. The treatment for both pemphigus and pemphigoid involves medicines to control symptoms, which may include:

  • Steroids, which reduce inflammation
  • Drugs that suppress the immune system response
  • Antibiotics to treat associated infections

Frequently Asked Questions

Managing pemphigus requires protecting fragile skin from trauma, so patients should wear loose, soft clothing made of natural fibers and avoid tight straps or rough fabrics. Oral care is critical; using a soft-bristled toothbrush, avoiding alcohol-based mouthwashes, and rinsing with a gentle saline or baking soda solution can reduce irritation. A soft, bland diet is recommended to minimize pain during eating. To prevent secondary bacterial infections in open sores, keep wounds clean and dry, avoid picking at scabs, and maintain strict hand hygiene. Sun protection is also advised, as UV exposure can exacerbate skin sensitivity.
Improvement usually begins within a few days to two weeks of starting high-dose corticosteroids or other immunosuppressants, with new blisters stopping and existing sores beginning to heal. However, complete remission and the ability to taper off medications safely often take several months to over a year. Patients must continue treatment even after symptoms disappear to prevent relapse, as the underlying autoimmune activity may persist. Regular follow-up with a dermatologist is essential to monitor for side effects and adjust dosages gradually.
Yes, certain medications, particularly those ending in -thiol (such as penicillamine) or -captopril, can trigger a form of pemphigus known as drug-induced pemphigus. In these cases, the primary management strategy involves discontinuing the offending medication under medical supervision. Symptoms may resolve once the drug is cleared from the body, though some patients may require short-term immunosuppressive therapy to control inflammation. It is crucial to inform your healthcare provider of all current medications, including over-the-counter drugs and supplements, to identify potential triggers.
The earliest sign is often the appearance of flaccid, fragile blisters that rupture easily, leaving behind raw, painful erosions. Unlike shingles, which follows a specific nerve pathway (dermatome), pemphigus blisters can appear anywhere on the skin and mucous membranes. A key clinical indicator is the Nikolsky sign, where gentle rubbing of the skin causes the top layer to slide off or existing blisters to spread laterally. Oral lesions, such as painful sores in the mouth, frequently precede skin symptoms by weeks or months and are a critical early warning sign that warrants immediate medical evaluation.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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