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September 1990

Pemphigus: An Alternative Approach to Treatment

Author Affiliations

Dermatology Service Veterans Administration Medical Center Martinez, CA 94553

Arch Dermatol. 1990;126(9):1238. doi:10.1001/archderm.1990.01670330118024

To the Editor.—  Pemphigus, from the Greek word meaning bubble, names a group of chronic skin diseases with an autoimmune basis.1 Two types of pemphigus occur—one type in which the acantholysis is high in the epidermis (pemphigus erythematosus/foliaceous), and the second more serious form in which the acantholysis is suprabasal (pemphigus vulgaris/vegetans). Untreated pemphigus, especially pemphigus vulgaris, is frequently a fatal disease.The cause of pemphigus is unclear. In pemphigus vulgaris, genetic factors appear to play a role in disease susceptibility. Recent evidence has shown an association of an HLA-DQ beta allele and susceptibility to this disease.2 The circulating antibodies that bind to the membrane of epidermal cells seem to play a critical role in pemphigus.3,4 For example, injection of human IgG containing the pemphigus vulgaris antibody into newborn mice causes the appearance of blisters that mimic, the human disease both clinically and histologically.5 Since disease

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