Pemphigus

Aka: Pemphigus, Intraepidermal Blister

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II. Definition

  1. Intraepidermal Acantholytic Blister
  2. Mnemonic: Pemphigus ends in S for Superficial
    1. Contrast with the deeper Pemphigoid

III. Types: Primary forms of Pemphigus

  1. Deep Pemphigus (above Basal Cell Layer of Epidermis)
    1. Pemphigus Vulgaris (most common and most severe)
    2. Pemphigus Vegetans (rare Pemphigus Vulgaris variant)
    3. Drug-Triggered Pemphigus (umasks Pemphigus Vulgaris)
  2. Superficial Pemphigus (involves Stratum Granulosum)
    1. Pemphigus Foliaceus
    2. Pemphigus erythematosus (Senear-Usher Syndrome)
    3. Pemphigus herpetiformis
    4. Fogo selvagem
    5. Pemphigus

IV. Types: Secondary forms of Pemphigus

  1. Paraneoplastic Pemphigus
  2. Drug-Induced Pemphigus (similar to Pemphigus Foliaceus)

V. Signs

  1. Flaccid Blister (superficial)
  2. Nikolsky's Sign
    1. Positive in Pemphigus Vulgaris
    2. Negative in Pemphigus Foliaceus (most superficial)

VI. Histology

  1. All Pemphigus conditions show epidermal Acantholysis

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