Pemphigus is an autoimmune disorder that causes painful blisters, bumps and scabs on the surface of the skin similar to eczema and often misdiagnosed as such. It often affects mucous membranes such as the nose, throat, tongue and genitals and can cause blisters in and around the mouth.
In pemphigus, auto-antibodies form against desmoglein which forms the 'glue' that attaches adjacent epidermal cells via attachment points called desmosomes. When auto-antibodies attack desmogleins, the cells become separated from each other and the epidermis becomes 'unglued', a phenomenon called acantholysis. This causes blisters that slough off and turn into sores. In some cases, these blisters can cover a significant area of the skin.
Studies indicate that this condition is quite rare, as it occurs in around only one out of a million people and cases are much higher in the Mediterranean region. There are three types of pemphigus:
NOTE: Hailey-Hailey disease, also called familial benign pemphigus, is an inherited (genetic) skin disease, not an autoimmune disease. It is therefore not considered part of the Pemphigus group of diseases.
Definitive diagnosis requires examination of a skin or mucous membrane biopsy by a professional dermatologist or oral pathologist.
Isothiocyanates, phenols, thiols and tannins are known to trigger outbreaks of pemphigus and therefore it is wise to try a two-week elimination of foods containing these compounds to see if the condition improves. If it does, then the foods can be added back into the diet one at a time with a four-day gap to see if that particular food triggers an attack.
Foods to avoid that contain isothiocyanates
Foods to avoid that contain phenols
Sources of phenols to avoid in the form of cinnamic acid
Foods to avoid that contain Tannins
NOTE: Tannins are more concentrated in the skins of fruits and nuts especially red and dark coloured fruits. Tannins can inhibit the absorption of vitamin B12 and iron.
Herbs and spices to avoid that contain high levels of tannins
Many foods contain added artificial tannins as a yellow colouring (annatto) or have been produced with tannin leaching from the wood during storage which have been shown to be detrimental to the health and may trigger pemphigus.
Food and drinks to avoid that may contain artificial tannins
Foods to avoid that are high in thiols
It is also important to avoid fried food, oily or greasy food, any form of sugar, caffeinated beverages, alcohol, soft drinks and juices, dairy products, salty food, hot spices, and processed and refined foods. Many processed foods have artificial additives that can contain the triggers for pemphigus.
Drugs that can trigger pemphigus
Foods that can be consumed during the elimination diet
NOTE: Although the above foods do not contain the elements that can trigger pemphigus, some may cause allergies for susceptible people.
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