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Tests and diagnosis
By Mayo Clinic staffBecause it's uncommon and because blisters occur with a number of conditions, pemphigus can be difficult to diagnose. Your doctor will ask you for a complete medical history and examine your skin and mouth. In addition, he or she may also look for the:
- Nikolsky sign. To look for this sign, your doctor will lightly rub a patch of normal skin near the blistered area with a cotton swab or finger. If you have pemphigus, the top layers of your skin are likely to shear off. This reaction is called the Nikolsky sign.
Other tests may include:
- Skin biopsy. In this test, a piece of tissue from a blister is removed and examined under a microscope. Examination of the biopsy tissue may also involve a process called direct immunofluorescence (DIF). DIF entails staining the tissue with fluorescent dye to make the antibodies "light up" under a special microscope so that they can be identified.
- Blood tests. The purpose of these tests is to detect and identify antibodies (anti-cell surface and anti-desmogleins) in your blood.
References
- Goldstein BG. Pemphigus. http://www.uptodate.com/home/index.html. Accessed April 6, 2010.
- Berger TG. Dermatologic disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment. 49th ed. New York, N.Y.: McGraw-Hill Medical; 2009. http://www.accessmedicine.com/content.aspx?aID=747. Accessed April 5, 2010.
- Stanley JR. Pemphigus. In: Wolff K, et al. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2970595. Accessed April 5, 2010.
- Pemphigus vulgaris. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec10/ch112/ch112f.html. Accessed April 5, 2009.
- Pemphigus. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Pemphigus/default.asp. Accessed April 5, 2010.
- Baroni A. Vesicular and bullous disorders: Pemphigus. Dermatologic Clinics. 2007;25:597.
- Gibson LE (expert opinion). Mayo Clinic, Rochester. April 9, 2010.
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