Pemphigus erythematosus

[3] Patients with pemphigus erythematosus typically present with flaccid scaling blisters on the face, scalp, and trunk in sun-exposed areas.

The proteins are destroyed or disabled by the immune system, leading to the separation of the skin layers, which causes the blisters.

[5] Patients with pemphigus erythematosus typically present with superficially eroded lesions, or vesiculobullae, that may ooze and crust.

The patient might not be aware that their condition is photosensitive, although the lesions frequently appear on sun-exposed areas and flare after prolonged exposure to the sun.

[1] The appearance of crusted blisters on the cheeks and under the eyes that avoid the mouth and nasolabial folds is highly specific for pemphigus erythematosus.

[1] Pemphigus patients experience an autoimmune reaction that targets desmosomes, which are the structures that hold skin cells together.

Patients with pemphigus have antibodies targeting their desmoglein proteins, triggering the immune system to destroy them.

The blisters often appear wet or crusted, which is caused by serous fluid leaking through the compromised skin barrier.

In turn, cellular proteins including desmogleins are released from the cell, becoming exposed to pemphigus antibodies, causing an inflammatory reaction.

[5] Alternative steroid-sparing therapies include methotrexate,azathioprine, mycophenolate mofetil, cyclophosphamide, and intravenous immunoglobulin.