Management of chronic wounds in patients with pemphigus

Pemphigus is a group of chronic IgG-mediated autoimmune blistering diseases that involves both the skin and mucous membranes. It is caused by autoantibodies disrupting intercellular keratinocyte adhesion. Loss of epidermal integrity clinically manifests as flaccid thin-walled blisters, erosions, and crusts on the skin, and painful mucosal erosions. Pemphigus vulgaris and pemphigus foliaceus are the two most common types of pemphigus. Although rare, pemphigus can be life-threatening. Substantial morbidity and mortality can occur as a result of complications of these diseases and their treatments. In general, pemphigus often results in extensive skin loss, leading to scar formation and adherence of articular skin folds, limiting joint and limb movements. The primary goal of treatment is to induce durable remission, decrease blister formation, prevent infections and promote healing of blisters and erosions. The mainstay of treatment for pemphigus is systemic corticosteroids combined with an adjuvant immunosuppressant and wound care. We performed PubMed and Google Scholar searches of the English-language literature for pemphigus disease and wound management for blistering disease (1966–2019). In this review, we discuss wound care in patients with pemphigus disease.