For over half of those affected spontaneous remission occurs within a few years with no further recurrence occurring. Pemphigus Although less common than pemphigoid, pemphigus is more dangerous since left untreated it can be fatal. It tends to start in middle age with blisters forming that are fragile and burst easily leaving raw patches of skin that do not heal without treatment. If firm pressure is exerted on unaffected skin and a shearing strain applied then a blister will appear. The blisters are frequently itchy and painful and feel as if the skin is burning.
Blisters usually appear in the mouth first.
Pemphigus foliaceus - Blisters do not occur in the mouth and those on the skin are more itchy than painful. Paraneoplastic pemphigus - the rarest but most serious form and often occurs when someone has a cancer. Pemphigus can run in families and although its precise cause is unknown a number of possible triggers have been identified. Some of these include penicillamine derived drugs, herpes simplex virus, solar irradiation, and long-term stress. Treatment and support Both pemphigoid and pemphigus require initial treatment with oral steroids.