Adjuvant Therapies of Pemphigus Vulgaris: A Review

Pemphigus vulgaris (PV) is an autoimmune disease characterized by blistering and erosions on skin and mucous membranes due to acantholysis. It is caused by autoantibodies against desmosomal caderins desmoglein 3 (Dsg 3) which are calcium dependent cell adhesion molecules. The measurement of Dsg 3-ELISA had been shown to be a sensitive and specific test for the diagnosis of PV in addition to the traditional indirect immunofluorescence autoantibodies titre. The incidence of the disease in the United States is about 0.42 per 100,000, equally affecting males and females. The exact incidence in Hong Kong is unknown. According to a study in Hong Kong Social Hygiene Service between 1985-1992, it was the second most common chronic bullous dermatosis; second to bullous pemphigoid. There were 38 cases of pemphigus vulgaris, which composed of 16.2% of all chronic bullous dermatoses. The male to female ratio was 1.4:1 and the majority of patients were between 50 to 69 years old.