Q. What is pemphigus? What is the best treatment?

A. Pemphigus is a general term that describes four different disease entities, which we refer to as the Pemphigus Complex, primarily limited to the skin. All are considered to be immune mediated diseases. The four different types are pemphigus vulgaris, pemphigus vegetans, pemphigus foliaceus and pemphigus erythematosus. Both the prognosis and treatment for pemphigus varies with the specific form of the disease and the severity of the disease in a particular patient. In general, pemphigus is treated with various immunomodulating agents, the most common of which is a glucocorticoid, such as prednisone. Glucocorticoids do not work in all patients, though other drugs, such as azathioprine; chlorambucil and cyclosporine are often used. What is critically important is to have a proper diagnosis made by biopsy of the lesions and referral of the biopsies to a dermatopathology specialist.

A specialist is critically important, because special stains (immunofluorescent types) are needed to determine which form of pemphigus is causing a problem. Also, a host of other things look like pemphigus, but are not actually pemphigoid diseases. These are often treated differently and can have systemic complications. After determining the exact cause of your kittys problem, you and your veterinarian can determine the best and most effective treatment.