{"id":7631,"date":"2013-03-04T11:41:31","date_gmt":"2013-03-04T16:41:31","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=7631"},"modified":"2013-03-08T16:48:33","modified_gmt":"2013-03-08T21:48:33","slug":"pemphigus-vulgaris","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/","title":{"rendered":"Pemphigus Vulgaris"},"content":{"rendered":"

Pathophysiology of pemphigus vulgaris<\/h4>\n

1)<\/strong> pemphigus vulgaris is an autoimmune bullous skin disease resulting from formation of a pemphigus antibody against desmoglein 1 an 3 molecules (component of desmosomes located between keratinocytes)
\n2)<\/strong> type 2 hypersensitivity reaction<\/p>\n

<\/p>\n

Signs and Symptoms<\/h4>\n

1)<\/strong> flaccid blisters in mouth, face, scalp, neck, axilla, and torso
\n2)<\/strong> itching and pain at site of lesions
\n3)<\/strong> skin becomes denuded
\n4)<\/strong> posthealing hyperpigmentation
\n5)<\/strong> blisters can ulcerate and become secondarily infected
\n6)<\/strong> severe cachexia
\n7)<\/strong> positive Nikolsky’s sign<\/p>\n

\"pemphigus<\/a>

Flaccid blisters seen in pemphigus vulgaris<\/p><\/div>\n

Characteristic Test Findings<\/h4>\n

IgG autoantibodies against epithelial cell desmogleins (1 and 3)<\/p>\n

Histology and Gross Pathology<\/h4>\n

1)<\/strong> epidermal cells lose cohesion (acantholysis) with formation of intraepidermal blisters
\n2)<\/strong> intact basal cells form blister base<\/p>\n

Associated Conditions<\/h4>\n

1)<\/strong> increased incidence in HLA-DR4 and HLA-DRw6
\n2)<\/strong> lesions can also occur in esophagus, pharynx, larynx, conjunctiva, rectum, and vagina<\/p>\n

Inheritance\/Epidemiology<\/h4>\n

occurs mostly in elderly patients<\/p>\n

Treatment<\/h4>\n

1)<\/strong> glucocorticoids (usually prednisone)
\n2)<\/strong> azathioprine or cyclophosphamide<\/a><\/p>\n

Tips for USMLE<\/h4>\n

1)<\/strong> Nikolsky’s sign is separation of epidermis when skin is manually pressed
\n2)<\/strong> if there are no mouth lesions, it is not pemphigus vulgaris
\n3)<\/strong> if question mentions denuded skin and flaccid blisters, think pemphigus vulgaris
\n4)<\/strong> if question mentions intraepidermal blisters, think pemphigus vulgaris<\/p>\n","protected":false},"excerpt":{"rendered":"

Pathophysiology of pemphigus vulgaris 1) pemphigus vulgaris is an autoimmune bullous skin disease resulting from formation of a pemphigus antibody against desmoglein 1 an 3 molecules (component of desmosomes located between keratinocytes) 2) type 2 hypersensitivity reaction<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[5151,11],"tags":[5424,5436,5438,5435,5437],"yoast_head":"\nPemphigus Vulgaris - InsideSurgery Medical Information Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pemphigus Vulgaris - InsideSurgery Medical Information Blog\" \/>\n<meta property=\"og:description\" content=\"Pathophysiology of pemphigus vulgaris 1) pemphigus vulgaris is an autoimmune bullous skin disease resulting from formation of a pemphigus antibody against desmoglein 1 an 3 molecules (component of desmosomes located between keratinocytes) 2) type 2 hypersensitivity reaction\" \/>\n<meta property=\"og:url\" content=\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/\" \/>\n<meta property=\"og:site_name\" content=\"InsideSurgery Medical Information Blog\" \/>\n<meta property=\"article:published_time\" content=\"2013-03-04T16:41:31+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2013-03-08T21:48:33+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/insidesurgery.com\/wp-content\/uploads\/2013\/03\/pemphigus-watermark.jpg\" \/>\n<meta name=\"author\" content=\"Editor\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Editor\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/\",\"url\":\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/\",\"name\":\"Pemphigus Vulgaris - InsideSurgery Medical Information Blog\",\"isPartOf\":{\"@id\":\"https:\/\/insidesurgery.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#primaryimage\"},\"thumbnailUrl\":\"http:\/\/insidesurgery.com\/wp-content\/uploads\/2013\/03\/pemphigus-watermark.jpg\",\"datePublished\":\"2013-03-04T16:41:31+00:00\",\"dateModified\":\"2013-03-08T21:48:33+00:00\",\"author\":{\"@id\":\"https:\/\/insidesurgery.com\/#\/schema\/person\/80c1e5c67f8a2c348e38e202270e8594\"},\"breadcrumb\":{\"@id\":\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\",\"caption\":\"Flaccid blisters seen in pemphigus vulgaris\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/insidesurgery.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Pemphigus Vulgaris\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/insidesurgery.com\/#website\",\"url\":\"https:\/\/insidesurgery.com\/\",\"name\":\"InsideSurgery Medical Information Blog\",\"description\":\"Details of surgical procedures, pathophysiology, signs and symptoms, and treatment of medical diseases,medical and surgical eponyms, and surgeons and surgery in the news\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/insidesurgery.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/insidesurgery.com\/#\/schema\/person\/80c1e5c67f8a2c348e38e202270e8594\",\"name\":\"Editor\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/insidesurgery.com\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/41c3c845307fcd3eff88632d6ccaf656?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/41c3c845307fcd3eff88632d6ccaf656?s=96&d=mm&r=g\",\"caption\":\"Editor\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Pemphigus Vulgaris - InsideSurgery Medical Information Blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/","og_locale":"en_US","og_type":"article","og_title":"Pemphigus Vulgaris - InsideSurgery Medical Information Blog","og_description":"Pathophysiology of pemphigus vulgaris 1) pemphigus vulgaris is an autoimmune bullous skin disease resulting from formation of a pemphigus antibody against desmoglein 1 an 3 molecules (component of desmosomes located between keratinocytes) 2) type 2 hypersensitivity reaction","og_url":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/","og_site_name":"InsideSurgery Medical Information Blog","article_published_time":"2013-03-04T16:41:31+00:00","article_modified_time":"2013-03-08T21:48:33+00:00","og_image":[{"url":"http:\/\/insidesurgery.com\/wp-content\/uploads\/2013\/03\/pemphigus-watermark.jpg"}],"author":"Editor","twitter_misc":{"Written by":"Editor","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/","url":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/","name":"Pemphigus Vulgaris - InsideSurgery Medical Information Blog","isPartOf":{"@id":"https:\/\/insidesurgery.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#primaryimage"},"image":{"@id":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#primaryimage"},"thumbnailUrl":"http:\/\/insidesurgery.com\/wp-content\/uploads\/2013\/03\/pemphigus-watermark.jpg","datePublished":"2013-03-04T16:41:31+00:00","dateModified":"2013-03-08T21:48:33+00:00","author":{"@id":"https:\/\/insidesurgery.com\/#\/schema\/person\/80c1e5c67f8a2c348e38e202270e8594"},"breadcrumb":{"@id":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#primaryimage","url":"","contentUrl":"","caption":"Flaccid blisters seen in pemphigus vulgaris"},{"@type":"BreadcrumbList","@id":"https:\/\/insidesurgery.com\/2013\/03\/pemphigus-vulgaris\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/insidesurgery.com\/"},{"@type":"ListItem","position":2,"name":"Pemphigus Vulgaris"}]},{"@type":"WebSite","@id":"https:\/\/insidesurgery.com\/#website","url":"https:\/\/insidesurgery.com\/","name":"InsideSurgery Medical Information Blog","description":"Details of surgical procedures, pathophysiology, signs and symptoms, and treatment of medical diseases,medical and surgical eponyms, and surgeons and surgery in the news","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/insidesurgery.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/insidesurgery.com\/#\/schema\/person\/80c1e5c67f8a2c348e38e202270e8594","name":"Editor","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/insidesurgery.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/41c3c845307fcd3eff88632d6ccaf656?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/41c3c845307fcd3eff88632d6ccaf656?s=96&d=mm&r=g","caption":"Editor"}}]}},"_links":{"self":[{"href":"https:\/\/insidesurgery.com\/wp-json\/wp\/v2\/posts\/7631"}],"collection":[{"href":"https:\/\/insidesurgery.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/insidesurgery.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/insidesurgery.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/insidesurgery.com\/wp-json\/wp\/v2\/comments?post=7631"}],"version-history":[{"count":0,"href":"https:\/\/insidesurgery.com\/wp-json\/wp\/v2\/posts\/7631\/revisions"}],"wp:attachment":[{"href":"https:\/\/insidesurgery.com\/wp-json\/wp\/v2\/media?parent=7631"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/insidesurgery.com\/wp-json\/wp\/v2\/categories?post=7631"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/insidesurgery.com\/wp-json\/wp\/v2\/tags?post=7631"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}