Nail disease may be the only finding and has prognostic value in management. Pemphigus foliaceus (PF) is the least severe of the three varieties. Desmoglein 1, the protein that is targeted by the autoantibodies, is enriched in the upper skin layers. PF is characterized by crusty sores that often begin on the scalp, and may move to the chest, back, and face. Mouth sores do not occur. This form is also frequent among Ashkenazi Jews. It is not as painful as PV, and is often misdiagnosed as dermatitis or eczema
Intraepidermal neutrophilic IgA dermatosis is characterized histologically by intraepidermal bullae with neutrophils, some eosinophils, and acantholysis. The least common and most severe type of pemphigus is paraneoplastic pemphigus (PNP). This disorder is a complication of cancer, usually lymphoma or Castlemans disease. It may precede the diagnosis of the tumor. Painful sores appear on the mouth, lips, and the esophagus. In this variety of pemphigus, the disease process often involves the lungs, causing bronchiolitis obliterans (constrictive bronchiolitis). Though much less frequent, it is still found the most in the Ashkenazi Jewish population. Complete removal of and/or cure of the tumor may improve the skin disease, but lung damage is generally irreversible. Endemic pemphigus foliaceus includes fogo selvagem, the new variant of endemic pemphigus foliaceus in El Bagre, Colombia, and the Tunisian endemic pemphigus in North Africa.Hailey-Hailey disease, also called familial benign pemphigus, is an inherited skin disease, not an autoimmune disease, so it is not considered part of the pemphigus group of diseases.
A physical examination may follow where a doctor may tap lightly on the skin to determine how much feeling is present. Depending upon the location of the symptoms occurring, a doctor may recommend some tests to determine the overlying cause of the hypoesthesia. These tests include imaging computerized axial tomography (CT) and magnetic resonance imaging (MRI) scans, nerve conduction studies to measure electrical impulses passing through the nerves in search of damage to the nerves, and various reflex tests. An example of a reflex test would be the patellar reflex test. Treatment
Treatment of hypoethesia are aimed at targeting the more broad disease or illnesses that has caused the side effect of sensation loss. See also
Anaphia
Dysesthesia
Hyperesthesia
Paresthesia
Raynaud syndrome


== References ==