Bullous Pemphigoid

By | May 21, 2015

Bullous pemphigoid is a rare type of skin infection that is marked by blisters on different areas of the skin. It can occur on any age group but is common in elderly people. It causes fluid filled lesions on different parts of the body like upper thighs, lower abdomen and even on the oral cavity. This rare condition develops due to autoimmune disorder when the body’s immune system attacks the outer layer of skin forming blisters.

This can be managed effectively by corticosteroids and other medications used for suppressing the immune system. However in most of the cases it is followed by remission and flaring in different intervals of time. Being a rare skin disorder, bullous pemphigoid affects 3-4 in one million people. It is common in some parts of Western countries.

Symptoms :

Bullous pemphigoid is characterized by large blisters carrying pus filled fluid. The skin will be red color in blister area and is largely found on the groin, lower abdomen and armpits. In rare cases it appears on the oral cavity making it difficult to eat and drink. The blisters are not painful but it can be itchy. In very rare cases it would affect the mucous membranes of the eyes affecting vision and causing soreness.

Before the appearance of blisters the skin area can become itchy. For some people it can cause erythematous rash on the skin before weeks of forming a blister. The formation of bullae is typical feature of this disorder and it can be widespread also affecting many parts of the body.

Who are at risk?

  • Bullous pemphigoid can develop on any person but often it occurs on people above 60 or 70 years.
  • It may develop on a person who has chronic inflammatory skin problems like psoriasis or lichen planus.
  • People who are taking strong medications like NSAID’s (Non steroidal anti inflammatory drugs), captopril, furosemide and antibiotics for long period of time are likely to develop this rare skin problem.
  • Exposure to harsh sunlight, UV radiation or undergoing radiotherapy can increase the risk of developing BP.

Causes :

Exact factor that triggers formation of bullous pemphigoid is not known. It can be due to autoimmune disorder in which body’s own immune system will attack the skin layer. The immune system would produce antibodies for attacking the epidermal layer of the skin causing inflammation and blisters. The thin layer of the skin gets affected causing itching. Prolonged use of certain medications like penicillin, sulfasalazine and exposure to ultraviolet rays and radiotherapy can cause bullous pemphigoid. In extreme cases, the blisters can develop infection causing life threatening conditions.

Diagnosis :

Your doctor will examine the blister on the skin. For confirmation he may do biopsy by cutting a small tissue sample for testing it on the lab. Direct immunofluorescence study is also done for confirming the presence of IgG protein on the affected skin.

Treatment :

The objective of the treatment is to help the patient to get relief from the symptoms of itching and to accelerate the healing process. Drugs like prednisone are given orally to control inflammation of the skin leading to blister formation. Clobetasol is highly effective corticosteroid in managing the first line symptoms on the skin. Corticosteroid ointment can be rubbed on the affected area of the skin for quick healing. But any drug of corticosteroid can cause adverse effect like weakening of bones, diabetes and hypertension.

Medications like azathioprine or mycophenolate mofetil are effective immune-suppressants to control the antibodies released by immune system. Anti inflammatory drug like trexall is effective if combined with corticosteroids. Your doctor will begin with low doses of corticosteroids to minimize the side effects. He would collect complete medical history of the patient and devise suitable treatment to suit the age and health condition of the patient. Within the first few weeks of starting corticosteroid drugs, the blisters would heal effectively and disappear. But there is a possibility of remission and hence most of the patients will have to continue treatment for 4-5 years.

Images, Pics, Photos and Pictures of Bullous Pemphigoid :

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Home Remedies :

It is really discouraging to have fluid filled blisters on the skin for extended period of time. You should accept the problem and continue taking medications in prescribed doses. The skin can become fragile making one prone to more injury. Hence it is good to cover the blister area with dry clothing to prevent infection. Since UV rays of the sun can trigger more blister formation avoid going out in the sun. It can be difficult to eat/drink with blisters on the mouth. Avoid taking hot and spicy foods and include frequent meals instead of sticking on to the routine. Bullous pemphigoid is a self limiting disorder and the symptoms will fade within 5 years.

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