Apoptosis and Signaling in Bullous Diseases: Pemphigus

Autoimmune bullous diseases comprise a heterogeneous group of disorders, which not only differ with regard to their immunological characteristics but also with regard to genetic and environmental predisposing factors. A strong association with HLA alleles was found in pemphigus, mucous membrane pemphigoid, pemphigoid gestationis and epidermolysis bullosa acquisita, whereas in bullous pemphigoid, this association appeared much less prominent. Recently, the first non-HLA genes have been associated with pemphigus vulgaris. In pemphigus vulgaris and foliaceus, the potential impact drugs, smoking and vaccination have been described, while in the endemic forms of pemphigus foliaceus, the role of environmental factors, including infectious agents, is emerging.