1604 Lamons Lane , Suite 202, Johnson City TN 37604

Pemphigus Treatment in Bristol, VA

Pemphigus Treatment in Bristol, VA

Do you have painful or itchy blisters on your skin, inside your mouth, or on your genital area? It could be pemphigus, a group of autoimmune disorders with causes not well understood by medical science.

Pemphigus is rare, but not unheard of. It can cause infection, gum disease, and even death in some cases, so seeking medical attention is vital.

To speak with a pemphigus specialist today in Bristol, call (423) 482-8711 or contact Dr. Dalal Akoury online.

What are the symptoms of pemphigus?

Pemphigus is identified by blisters on your skin or mucous membranes, which is the skin of your mouth, lips, and genitals. The blisters are soft and tend to break open quickly, leaving painful sores that get infected easily. These sores typically heal slowly. Some may never heal.

Pemphigus can become chronic, but treatment may eliminate symptoms completely. Effectiveness varies from patient to patient and depends on a large number of factors.

Seeking medical attention is important because blisters can be caused by many different health conditions – some common, others life-threatening:

  • insect bites or stings
  • extreme heat or cold (sun poisoning or frostbite)
  • exposure to certain chemical irritants
  • warts
  • fungal skin infections
  • chicken pox
  • herpes
  • impetigo
  • eczema

See your healthcare provider to diagnose or rule out pemphigus and other underlying conditions.

What causes pemphigus?

The causes and triggers of pemphigus are not well understood, but it has been identified as an autoimmune disorder.

A healthy immune system attacks foreign bodies like viruses and bacteria. In people affected by pemphigus, the immune system produces antibodies that attack the patient's healthy skin cells.

In rare cases this condition occurs as a side effect of medications, such as blood pressure drugs, so symptoms disappear when you stop taking the medication.

Middle-aged and older people are at a higher risk of developing pemphigus. People of Jewish heritage also have a higher risk of developing pemphigus vulgaris.

There are several different types of pemphigus. These include vulgaris, foliaceus, drug-induced, fogo selvage, and paraneoplastic.


Vulgaris symptoms include painful blisters first on your mouth, followed by blisters on your skin or genitals. These blisters usually don't cause itching, but they can make eating or swallowing difficult.


This type typically doesn't affect your mouth or genital skin, and the blisters usually aren't painful. They most commonly appear on your chest, back, and shoulders and make your skin crusty and itchy.


Drug-induced pemphigus occurs as a side effect of certain medications, usually penicillin derivatives and types called thiol-associated. Why this effect occurs is not well-known. Stopping the medication is essential whenever possible, but the symptoms don't always resolve when the medication leaves your system.

Fogo selvagem

This type mostly affects the rural areas of midwestern and southern Brazil, as well as Tunisia, Peru, Paraguay, El Salvador, and Colombia. It mostly affects children and young adults and is closely associated with poverty and malnutrition. Scientists believe a genetic susceptibility to certain biting insects causes an immune response, which then causes pemphigus.


The rarest type of pemphigus is also the most serious. It occurs when your body is fighting certain forms of cancer. This type can affect your respiratory and gastrointestinal tracts, strongly increasing the risk of the pemphigus becoming fatal.

Pemphigus is not a sexually transmitted disease (STD), and it's never contagious. You cannot catch pemphigus by coming into close contact with an affected person, the objects they touch, or any of their bodily fluids.

How is pemphigus diagnosed?

Getting medical care immediately is vital. In some cases, pemphigus can be life-threatening. Diagnosing or ruling out this condition as early as possible helps you manage its symptoms and avoid catastrophic complications.

First, your healthcare provider will examine you. You'll also discuss your medical history and any medications you're taking. If pemphigus is suspected, you may undergo a number of tests. These include:

  • rub test: a patch of your skin is rubbed with a cotton swab; the top layer of your skin shearing off is a strong sign of pemphigus
  • skin biopsy: a piece of tissue from a blister is removed and examined under a microscope
  • blood tests: to detect antibodies called desmogleins, which are elevated when pemphigus is first diagnosed but decrease as your symptoms improve
  • endoscopy: a thin, flexible tube inserted into your throat to detect blisters or sores from pemphigus vulgaris

How is pemphigus treated?

This autoimmune disease compromises your immune system, so whatever treatment you and your healthcare provider choose should not be "boosting" or enhancing your immune system, as it will also boost your disease activity. Treatment revolves around reducing symptoms and preventing complications.

Many patients relieve symptoms with these pharmaceutical medication, though it often takes years to get full relief:

  • corticosteroids creams or pills: long-term use can have side effects like increased blood sugar, unwanted hair growth, higher risk of infection, cataracts, glaucoma, acne, and redistribution of body fat
  • immunosuppressants: medications to help stop your immune system from attacking your health tissue; may have serious side effects, such as increased risk of infection
  • biological therapies: an injected drug called rituximab targets white blood cells that produce pemphigus antibodies; potential side effects include difficulty moving limbs, speech problems, vision loss
  • antibiotics, antivirals, and antifungal medication: used for controlling infections; side effects include colitis, seizures, jaundice, hives, and rashes
  • dapsone: side effects include blurred vision, ringing in the ears, fast heartbeat, chest pain, difficulty urinating

For a gradual approach without potentially severe side effects integrative treatments include:

  • fish oil and coconut oil: antibacterial and antifungal properties; fatty acids reduce inflammation; can be safely eaten and applied to affected areas
  • vitamin D: helpful for your immune system; up to 10,000 IUs per day has been tested and is considered safe; sun exposure also helps your body produce vitamin D, but wear sunscreen and take precautions before exposing your skin to the sun to prevent sunburn
  • vitamin C: vital for a strong immune system, which protects against autoimmune diseases; can be taken in supplement form and found in citrus fruit like lemons and oranges; about 2000 milligrams per day is recommended
  • aloe: soothes skin and can relieve itching and the effects of blisters; best used in its raw form instead of in lotion or cream; do not eat or swallow aloe, as it can cause abdominal cramps and diarrhea
  • healthy diet: lots of fresh fruit and vegetables, water, whole grains, and avoiding processed and overly sugary and salty foods
  • exercise: 30-40 minutes of moderate exercise per day improves blood pressure, reduces body fat, stabilizes immune system

For more severe cases these hospital treatments may be required:

  • IV fluid replacement: skin sores can cause serious fluid loss, so replacing those fluids is crucial to your treatment
  • intravenous feeding: if mouth sores make eating too difficult, you may receive nutrition through a tube placed through your nose that reaches your stomach
  • anesthetic mouth treatment: if the pain from mouth sores is severe, you'll be given medications to reduce or eliminate it
  • therapeutic plasmapheresis: your blood's fluid (plasma) is removed using a cell separator and replaced with donated plasma or IV fluid; aims to get rid of the antibodies attacking your skin

Reserve Your Appointment Now

While some forms of pemphigus are mild and not dangerous, other forms can be life-threatening. Seeking medical attention is crucial so you can diagnose or rule out pemphigus and get treatment if necessary. Chronic pemphigus can become very painful if left untreated, so seeing your healthcare provider can help you manage its symptoms and get relief.

To speak with a pemphigus specialist today in Bristol, call (423) 482-8711 or contact Dr. Dalal Akoury online.

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Hours and Directions
AWAREmed Health and Wellness Resource Center


1604 Lamons Lane
Suite 202
Johnson City, TN 37604
(423) 482-8711


Mon: 9:00 am - 5:00 pm
Tue: 9:00 am - 5:00 pm
Wed: 9:00 am - 5:00 pm
Thu: 9:00 am - 5:00 pm
Fri: 9:00 am - 5:00 pm

Areas We Service:

Asheville, NC, Granite Falls, NC, Hudson, NC, Lenoir, NC, Hickory, NC, Boone, NC, North Wilkesboro, NC, Wilkesboro, NC, Greenville, SC, Morristown, TN, Knoxville, TN, Gatlinburg, TN, Kingsport, TN, Bristol, VA, Abingdon, VA