Pemphigus in India

Abstract

Pemphigus is a chronic epidermal immunobullous disease with potentially fatal outcome. The journey of literature on pemphigus in India has come a long way in last five decades. Pemphigus in Indian patients has unique genetic, clinical, and epidemiological differences from those in the Western countries. Corticosteroids remain the mainstay of treatment for pemphigus. Dexamethasone-cyclophosphamide pulse therapy has revolutionized the management of pemphigus in India and abroad for nearly 3 decades now. Corticosteroid-based treatment, along with adjuvants, has significantly brought down the high mortality rates that had been observed in precorticosteroid era. Present day research is largely based on elucidating the pathogenesis beyond the antidesmoglein antibodies, and newer diagnostic and treatment approaches. In this article, we review various aspects of literature on pemphigus in India, on Indians abroad, or literature from other countries that are considered relevant to the topic.

A study of clinical, histopathological and direct immunofluorescence diagnosis in pemphigus group Utility of direct immunofluorescence

“…That is why this method is crucial in the diagnosis of autoimmune intraepidermal and subepidermal bullous diseases. Chams-Davatchi et al described positive DIF in 93.28 % of cases of PV (5), Deepti et al in 94.11 % of cases (17) and Kanwar et al up to 100 % of the cases (21). In our study, DIF was positive in 91.3 % of samples.…”

Pemphigus vulgaris presenting as bleeding gums: A case report

“…Indirect immunofluorescence can differentiate PV from pemphigoid. Diagnosis is confirmed by IgG and other C3 antibodies which bind to skin or mucosa causing intraepithelial blistering (14).…”

Oral Pemphigus Vulgaris: Case Report

“…Indirect immunoflorescence is helpful in further distinguishing pemphigus from pemphigoid and other chronic oral lesions and is useful in following the progress of patient for pemphigus. The diagnosis is confirmed by the characteristic deposition of IgG and other C3 antibodies that bind to cell surface of perilesional skin or mucosa (13,14). Indirect immunoflorescence is less sensitive than direct immunofluorescence, but may be helpful if biopsy is difficult.…”