This is a major characteristic of pemphigus vulgaris. This is a chronic disease which is mediated by Immunoglobulin G antibody or IgG. Immunoglobulin G is thought to react in the skin in such a way as to break intercellular junctions of the epidermis and in particular that of keratinocytes. This leads in turn to separation of these cells from each other, a process which is called acantholysis. This in turn leads to the formation of vesicles that contain keratinocytes. There are accompanying to this disease several systemic symptoms such as fever and weight loss. This is a potentially life threatening disorder that can lead to death if left untreated. Treatment of this disorder includes the administration of drugs that suppress the action of the immune system such as steroids. If you suspect this is the disorder you are identifying, try to make sure the person receives medical attention as quickly as possible.;
, It differs than pemphigus vulgaris in that it usually affects persons between the ages of 60 and 80. It differs than pemphigus vulgaris also by the lack of oral lesions. It is however, similar to pemphigus vulgaris in that it is mediated by the action of immunoglobulin G also. It is thought to deposit in the skin basement membrane. This causes the basal cells to detach from the dermal layer of the skin. This in turn leads to the formation of subcutaneous vesicles which contain predominantly white blood cells.
 This disease is common between the ages of 20 to 40 years. This disorder has strong association with gluten induced enteritis or celiac disease. In spite of the apparent link between the two disorders removal of gluten from the diet does not improve the dermatitis. It is mediated by the action of immunoglobulin A instead of immunoglobulin G. Clinically speaking, this is a chronic disease with relapses and remission. The treatment to this condition is also by suppression of the overactive immune system with steroids.
 Skin pathology in this condition can arise as a separate condition or accompanied by other organs in the body. The isolated skin disorder is called discoid lupus erythematosus while that involves other organs is called systemic lupus erythematosus. They differ by the fact that systemic lupus erythematosus has a deposition of immunoglobulin G in the basement membrane of the skin of both diseased and healthy skin, while discoid lupus erythematosus is manifested by deposition of IgG in the affected area only.



Psoriasis. This disorder is as was mentioned idiopathic in which its cause is unknown. The disease is common and affects approximately 1% of the total population. It has a chronic course with remissions and exacerbations. Often the nails of affected persons are involved. The disorder is manifested by the excessive formation of keratinocytes in the basal layer of the skin. This leads in turn to more formation of keratin and its deposition in the epidermis. This disorder is sometimes linked to joint diseases that are similar to rheumatoid arthritis.
Lichen planus. This disorder has a chronic course in which women are more affected than men. This disorder is manifested by a decrease in cell proliferation. This leads in turn to more keratin formation with hyperkeratosis.
Erythema multiforme. This disorder is a common disease and can affect people with any age. It is associated with many disorders such as cancer and autoimmune diseases.
Look for large blisters on the skin and the oral cavity, especially in people between the ages between 40 and 60 years..
If there are large blisters on the skin but not in the oral cavity, consider the possibility of bullous pemphigoid in older patients.
Look for erythematous vesicles in younger subjects.
Check for the symptoms of lupus: Butterfly-shaped rash (malar rash) on the face that covers the cheeks and bridge of the nose, skin lesions that appear or worsen with sun exposure, mouth sores, and hair loss (alopecia).This disorder can affect many organs in the body including the skin.
Learn to recognize the symptoms of idiopathic skin diseases (skin diseases that are idiopathic or their etiology is not known).
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