Diagnosis and classification of pemphigus and bullous pemphigoid

Ruben Kershenovich, Emmilia Hodak, Daniel Mimouni*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Pemphigus and bullous pemphigoid represent the two major groups of autoimmune blistering diseases. Pemphigus has three major variants: pemphigus vulgaris, pemphigus foliaceus and paraneoplastic pemphigus and is characterized by autoantibodies directed against the cell surface of keratinocytes, producing acantholysis that in turn leads to intraepithelial blisters in the skin and/or mucous membranes. In bullous pemphigoid, the autoantibodies are present at the dermo-epidermal junction and attack the hemidesmosomes, causing subepidermal blister formation. The classification of the major variants of both the pemphigus group and bullous pemphigoid can be based on the combination of clinical, histopathological and immunopathological criteria. Many tools are available for the diagnosis of these entities including biopsy, direct and indirect immunofluorescence, immunoprecipitation, immunoblotting and ELISA. However, currently there are no generally accepted criteria for the diagnosis of these disorders. The present review provides a proposal for diagnostic criteria.

Original languageEnglish
Pages (from-to)477-481
Number of pages5
JournalAutoimmunity Reviews
Issue number4-5
StatePublished - Apr 2014


  • Bullous pemphigoid
  • Clinical classification
  • Criteria
  • Diagnosis
  • Pemphigus


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