Pemphigus, a group of rare autoimmune blistering diseases, is commonly mistaken for other blistering skin conditions due to similar clinical presentations of sores, erosions, and blisters. Key, frequently misdiagnosed conditions include bullous pemphigoid, Hailey-Hailey disease, bullous impetigo, aphthous stomatitis, and erythema multiforme.

What can be mistaken for pemphigus vulgaris?

Pemphigus is sometimes confused with other autoimmune blistering skin conditions such as bullous pemphigoid, lupus erythematosus and Hailey-Hailey disease.

What is a pemphigoid rash in pregnancy?

Pemphigoid gestationis is a rare pregnancy-associated immunobullous reaction characterised by an itchy rash that develops into blisters. It is most common during the second and third trimesters of pregnancy. It was previously known as herpes gestationis although it has no association with the herpes virus.

What are autoimmune bumps on hands?

Palmoplantar pustulosis is an autoimmune disorder marked by the appearance of fluid-filled pustules or blisters on the hands and feet. Autoimmune disorders cause the immune system to attack healthy cells. In the case of palmoplantar pustulosis, the immune system attacks the healthy skin on the hands and feet.

How to confirm pemphigus?

In addition, you may have tests, including:

1. A biopsy. A biopsy is a procedure to remove a sample of tissue for testing in a lab. To test for pemphigus, a piece of the blister is used.
2. Blood tests. One purpose of these tests is to detect and identify antibodies in your blood that are known to be present with pemphigus.

Dealing with Pemphigus disease

What blood test is done for pemphigus?

Serum Tests

In addition to DIF microscopy, evaluation for pemphigus involves detection and identification of circulating autoantibodies, including IgG cell surface antibodies against desmoglein 1 and 3, which are highly characteristic of pemphigus. Available serum tests include IIFs and ELISAs.

What are the first signs of pemphigus?

The main symptom of pemphigus is blistering of the skin and in some cases, the mucosal surfaces, such as the inside of the mouth, nose, throat, eyes, and genitals. The blisters are fragile and tend to burst, causing crusty sores.

Is pemphigoid always itchy?

Bullous pemphigoid (BUL-us PEM-fih-goid) is a rare skin condition that causes large fluid-filled blisters. They often appear on the skin near creases, such as the upper thighs and armpits. Sometimes, people get a rash instead of blisters. The affected areas may be painful and are usually very itchy.

What autoimmune disease gets worse during pregnancy?

Immune Thrombocytopenia (ITP)

If not treated during pregnancy, immune thrombocytopenia tends to become more severe. The antibodies that cause the disorder may cross the placenta to the fetus.

Which is the most distinct and definitive characteristic that distinguishes pemphigus from pemphigoid?

Pathologic Features

The lamina propria has a chronic inflammatory infiltrate and increased vascularity. Intramucosal acantholysis (Tzanck cells, tombstone cells) is not present; this histologic feature distinguishes pemphigus from pemphigoid.

When your immune system attacks your skin?

Cutaneous lupus, or skin lupus, is an autoimmune disease that affects your skin, causing skin rashes. Autoimmune diseases happen when your immune system mistakenly attacks your own body tissues. In cutaneous lupus, your immune system attacks your skin cells, causing chronic inflammation in your skin.

How did I get pemphigus vulgaris?

Pemphigus vulgaris is not fully understood. Experts believe that it's triggered when a person who has a genetic tendency to get this condition comes into contact with an environmental trigger. This might be a chemical or a medicine. In rare cases, pemphigus vulgaris will go away once a trigger is removed.

What does lupus hair look like?

Hair loss in lupus is usually characterized by dry, brittle hair that breaks, and hair loss is more common around the top of the forehead. Physical and mental stress can also cause hair loss, as can certain medications, including corticosteroids such as prednisone.

What are the first warning signs of lupus?

Early warning signs of lupus often include extreme fatigue, joint pain/swelling, unexplained fevers, skin rashes (especially a butterfly-shaped one on the face), hair loss, and sun sensitivity, but symptoms vary greatly, appearing slowly and sometimes mimicking other illnesses. Other common signs include mouth/nose sores, swollen glands, Raynaud's phenomenon (fingers/toes turning white or blue in the cold), and chest pain, often developing in waves (flares).

What does lupus tongue look like?

People with lupus can develop red ulcers on the lips, the tongue, and the inside of the mouth. A white halo surrounds these ulcers, and they may or may not cause irritation. Those experiencing a “flare-up” can develop ulcers quite quickly.

What is the blood test for pemphigus?

Circulating antibodies in pemphigus vulgaris can be detected by two serum tests: Indirect immunofluorescence (IIF) tests (#013, #025) for IgG and IgG4 intercellular antibodies/cell surface antibodies.

What are early warning signs of autoimmune disease?

Early warning signs of autoimmune diseases often include persistent, unexplained fatigue, joint pain, and muscle aches, coupled with inflammation (swelling, redness, heat), low-grade fevers, skin rashes (like a butterfly rash), digestive issues, and "brain fog" (difficulty concentrating). Because these symptoms overlap with many other conditions, early diagnosis can be tricky, so seeing a doctor for persistent new symptoms is crucial.
 

Where is the most common site of pemphigoid?

Most commonly, pemphigoid causes red skin patches on which blisters can appear. Any part of the skin can be involved, but the most common sites for the blisters are the body folds, hands, feet and the skin on the abdomen (belly area). In severe cases, the blisters can occur all over the body or in the mouth.

What labs would be abnormal with autoimmune disease?

The inflammatory markers are not diagnostic of inflammation, but reflect abnormalities that are seen in autoimmune diseases, infections, malignancies and other illnesses.

• Erythrocyte sedimentation rate (ESR) ...
• C-reactive protein (CRP) ...
• Ferritin. ...
• Ceruloplasmin. ...
• Fibrinogen. ...
• Haptoglobin. ...
• Albumin.

What is the Sjogren's syndrome?

In Sjogren's syndrome, your immune system attacks the glands that make moisture in the eyes, mouth, and other parts of the body. This causes a dry mouth and dry eyes. You may have dryness in other places that need moisture, such as your nose, throat, and skin.

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