This week’s Ask A Doctor Kenya Question is about pemphigus vulgaris treatment.
Dear Doctor, my grandfather has developed blisters all over his body. These blisters are filled with water and they burst and leave wounds on the skin. What is this skin disease and how can it be treated?
Ask A Doctor Kenya Answer – Pemphigus Vulgaris Treatment
These large blisters on the body are suggestive of a condition known as pemphigus vulgaris.
Pemphigus vulgaris is an immunobullous disease in which the immune system produces autoantibodies that attack structures within the skin. This results in the development of bullae or blisters on the chest, back. arms, legs and other parts of the body.
These blisters have very thin walls and so they rupture very easily and leave open wounds which can become infected.
These wounds eventually form scabs and heal without scarring though they may leave some discoloration on the skin.
Other symptoms of pemphigus vulgaris include wounds in the mouth which make eating difficult as well as in the larynx or throat which can make the voice hoarse and cause pain when swallowing. There may also be wounds in the nose and genital organs.
Pemphigus vulgaris usually affects men and women aged between 50 and 60 years.
You need to Consult Us so that we can do a Skin Biopsy and confirm the diagnosis before starting treatment. This is because there are many other conditions that can present with blisters. These include other immunobullous disease like bullous pemphigoid, dermatitis herpertiformis, erythema multiforme and toxic epidermal necrolysis.
Other skin conditions in which patients also develop blisters include impetigo, SSSS (Staphylococcal Scaled Skin Syndrome), acute eczema, chicken pox, herpex simplex and herpes zoster.
Blood tests like indirect immunofluorescence can also be done to check for antibodies.
Pemphigus vulgaris treatment is done with prescription medications like corticosteroids and other drugs that suppress the immune system.
Ideally, treated should be started when the patient is admitted because this pemphigus vulgaris has a high mortality rate due to complications. These complications include secondary bacterial infections, viral infections (like herpes), fungal infections (like candida).
Once it is under control, the patient can then be discharged to continue with their medication at home.