Bullous pemphigoid

Causes and Risks:
The blisters of bullous pemphigoid usually appear on the areas of the body that flex or move (flexural areas). About one-third of persons with bullous pemphigoid also develop blisters in the mouth. The disorder may occur in various forms, from no symptoms, to mild redness and irritation, to multiple blisters. The cause is not known, but may be related to immune system disorders.

Bullous pemphigoid typically occurs in elderly persons and is rare in young people. It is characterized by a pattern of exacerbations and remissions. It may be without symptoms for 5 or 6 years, then suddenly flare up.

Prevention:
There is no known way to prevent this disorder.

Symptoms:



Signs and Tests:
Skin lesion biopsy shows subepidermal blister (a blister that occurs beneath the outer skin layer and the inner skin layers) and immunoglobulin deposits.

Treatment:
Treatment is focused on relief of symptoms and prevention of infection.

Corticosteroids are the treatment of choice. They are given by mouth or by injection. Topical (applied to a localized area of the skin) corticosteroids may also be used on early, localized lesions.

Other medications may include chemotherapy medications such as methotrexate, azathioprine, or cyclophosphamide. Antibiotics such as tetracycline or erythromycin may also be given. Niacin (a B complex vitamin) may also be used to manage this condition.

Prognosis:
Bullous pemphigoid is a relatively benign disorder that tends to be chronic , with flare-ups after long remissions.

Complications:
Infection of the skin lesions is the most common complication.

Call Your Healthcare Provider:
Call your health care provider if symptoms indicate bullous pemphigoid may be present.

Call your health care provider if fever , redness or pain of the skin, drainage that looks like pus, or other signs of infection occur.


Pemphigus is classified as one of the blistering diseases. These is a close-up picture of typical lesions. Very small blisters are called vesicles. Larger blisters, like these, are called bullae.



Bullous pemphigoid is an autoimmune disorder (the body's immune system attacks the body), found mostly in middle-aged or elderly people. This disorder is characterized by tense blisters, usually located on the flexural surfaces (inside of the joint - such as the inside of the elbow or back of the knee). This disorder is characterized by periods of remission and exacerbation (worsening). Healing usually occurs without scarring.



Bullous pemphigoid is an autoimmune disorder (the body's immune system attacks the body) found mostly in middle-aged or elderly people. This disorder is characterized by tense blisters, usually located on the flexural surfaces (inside of the joint - such as the inside of the elbow or back of the knee). This disorder is characterized by periods of remission and exacerbation (worsening). Healing usually occurs without scarring. This picture is a close-up of bullous lesions around the anus.



Bullous pemphigoid is an autoimmune disorder (the body's immune system attacks the body) found mostly in middle-aged or elderly people. This disorder is characterized by tense blisters, usually located on the flexural surfaces (inside of the joint - such as the inside of the elbow or back of the knee). This disorder is characterized by periods of remission and exacerbation (worsening). Healing usually occurs without scarring. This picture is a close-up of lesions in the mouth. About one third of the people with bullous pemphigoid develop lesions in the mouth.



This picture shows bullous pemphigoid on the leg. Affected individuals develop tense blisters (bullae) filled with a yellowish blood-tinged (serosanguineous) fluid. Red (erythematous) plaques in this disease are the urticarial plaques preceding bullae (vesicles) formation or cellulitis from infection of open skin.



This picture shows bullous pemphigoid on the palm. There are areas where large blisters (bullae) have ruptured and the area has crusted over.