Pemphigus Vulgaris

  • Brit Long
  • Alex Koyfman


Pemphigus vulgaris is associated with high mortality if not treated. The classic clinical course is painful mucosal blisters and skin erosions. Mucosal lesions most commonly occur in the mouth, but any mucosal surface may be involved. Cutaneous blisters and bullae usually occur after mucosal lesions form, are typically painful and not pruritic, and are associated with positive Nikolsky sign. Fever is atypical and suggests superinfection. Diagnosis is clinical in the emergency department but can be confirmed with biopsy. Extensive lesions, severe superinfection, and toxic appearance require admission. Management includes systemic glucocorticoids, oral care, skin care, and adjunctive treatments as needed to facilitate resolution of lesions. Complications include electrolyte disorders, hypovolemia, secondary infection, and medication side effects. Superinfection can result in severe morbidity and mortality.


Pemphigus vulgaris Bullae Blister Nikolsky Rash Superinfection 



The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the US Army Medical Department, the US Army Office of the Surgeon General, the US Department of the Air Force, the US Department of the Army or the Department of Defense, or the US Government.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Brit Long
    • 1
  • Alex Koyfman
    • 2
  1. 1.Department of Emergency MedicineBrooke Army Medical CenterFort Sam HoustonUSA
  2. 2.Department of Emergency MedicineThe University of Texas Southwestern Medical CenterDallasUSA

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