Bullous pemphigoid

  • Definition
    • Bullous pemphigoid is a skin disorder characterized by large blisters.

  • Causes
    • Bullous pemphigoid is an autoimmune disorder which occurs when the body's immune system attacks and destroys healthy body tissue by mistake.

      This disorder usually occurs in older persons and is rare in young people. Symptoms come and go. In most patients, the condition goes away within 5 years.

  • Symptoms
    • Some people have no symptoms. Others may have mild redness, itching and irritation.

      In many cases, they are many blisters, called bullae. Blisters are usually located on the arms, legs, or middle of the body. The blisters may break open and form ulcers or open sores. Some people also develop blisters in the mouth.

      Other symptoms may include:

  • Exams and Tests
    • Tests that may be done to help diagnose this condition include:

      • Blood tests
      • Skin biopsy of the blister or the area next to it
  • Treatment
    • Powerful anti-inflammatory medicines called corticosteroids may be prescribed. They may be taken by mouth or applied to the skin. Medicines to help suppress the immune system may be prescribed.

      Antibiotics in the tetracycline family may be useful. Niacin (a B complex vitamin) is sometimes given along with tetracycline.

  • Outlook (Prognosis)
    • Bullous pemphigoid usually responds well to treatment. Most patients stop taking medicine after several years. The disease sometimes returns after treatment is stopped.

  • Possible Complications
    • Skin infection is the most common complication.

  • When to Contact a Medical Professional
    • Call your doctor for an appointment if you have:

      • Unexplained blisters on your skin
      • An itchy rash that continues despite home treatment
  • References
    • Bernard P, Borradori L. Pemphigoid group. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 30.

      Scott M, Werth VP. Bullous pemphigoid. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 32.