Pemphigus Foliaceous

Pemphigus Foliaceous (PF) is an autoimmune disease in which antibodies are directed against the structures which hold the epithelial cells of the skin together. This results in a severe crusting dermatosis that may wax and wane and is often mistaken for Staph infection or allergic skin disease.

Some patients with this disease will feel ill and have a fever while others will not. Achieving a diagnosis can be difficult as it is essential that the correct lesions be biopsied at exactly the right time.

Misdiagnoses are very common prior to referral to the dermatologist. This is especially true for cats as the key diagnostic pustular lesions that need to be biopsied are more transient and difficult to identify in felines with PF.

Treatment for PF involves using immunosuppressive medications to stop the antibody attack on the skin. The treatment for dogs usually consists of immunosuppressive doses of steroids along with a steroid-sparing agent like azathioprine.

Alternative medications are available if these are not tolerated.

Treatment choices in cats with PF are different than in dogs. Monitoring of blood work for adverse reactions to the medications (idiosyncratic liver damage, bone marrow suppression) is mandatory.

Side-effects of treatment can be worse than the disease itself so it is important that the patient undergo recheck examinations on a strict schedule. Due to the complexity of management of this disease, diagnosis and treatment of PF by a board-certified veterinary dermatologist is strongly recommended.