A skin lesion biopsy shows acantholysis. An examination of the biopsy tissue with immunofluorescence confirms pemphigus. The Tzanck test of a smear from the base of a blister shows acantholysis. Severe cases of pemphigus are treated similarly to severe burns . Treatment may require hospitalization, including care in a burn unit or intensive care unit.
Treatment is aimed at reducing symptoms and preventing complications.
Intravenous fluids, electrolytes , and proteins may be required. Mouth ulcers may necessitate intravenous feedings, if severe. Anesthetic mouth lozenges may reduce pain of mild to moderate mouth ulcers. Systemic therapy as early as possible is required to control pemphigus, but side effects from systemic therapy are a major complication. Localized treatment of ulcers and blisters may include soothing or drying lotions, wet dressings, or similar measures.