Overview
Clinical Pattern and Mechanism
Pemphigus vulgaris is an autoimmune blistering disease, not an infection or a pressure injury.
REx-PN
REx-PN
Pemphigus vulgaris is an autoimmune blistering disease, not an infection or a pressure injury. IgG autoantibodies against desmoglein 1 and desmoglein 3 disrupt adhesion between epidermal keratinocytes. This acantholysis creates a superficial, fragile blister roof. The hallmark pattern is flaccid bullae that rupture with minor friction and leave painful erosions. Persistent, painful oral erosions often interfere with eating and may precede skin disease. Lateral pressure may produce epidermal shearing, but a Nikolsky sign supports fragility and does not establish the diagnosis. Avoid deliberately repeating it. Barrier loss and mucosal disease can lead to pain, secondary infection, fluid loss, poor nutrition and impaired swallowing. Ocular or laryngeal involvement can threaten vision or the airway.
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