Blisters occur with a number of conditions, so pemphigus can be difficult to diagnose. Your doctor will ask you for a complete medical history and examine your skin and mouth. In addition, he or she may:

  • Check for skin peeling. Your doctor will lightly rub a patch of normal skin near the blistered area with a cotton swab or finger. If you have pemphigus, the top layers of your skin are likely to shear off.
  • Do a skin biopsy. In this test, a piece of tissue from a blister is removed and examined under a microscope.
  • Run blood tests. One purpose of these tests is to detect and identify antibodies in your blood known as desmogleins. These antibodies are often elevated when pemphigus is first diagnosed. The levels of these antibodies usually goes down as symptoms improve.
  • Order an endoscopy exam. If you have pemphigus vulgaris, your doctor may have you undergo endoscopy to check for sores in the throat. This procedure involves inserting a flexible tube (endoscope) down your throat.